Coronary artery disease burden and long-term outcomes in patients with human immune deficiency virus (HIV) undergoing percutaneous coronary intervention: results from a single-center registry

Abstract

Purpose: Coronary artery disease (CAD) is a frequent complication of HIV infection and patients with HIV are increasingly referred for percutaneous coronary intervention (PCI). Despite substantial cardiac morbidity, the angiographic pattern or burden of CAD and outcomes following PCI in HIV patients has not been well described. Methods: We followed 112 consecutive patients with HIV who underwent PCI from 1999 to 2011. Quantitative coronary angiographic (QCA) analysis was performed independently in all patients. We determined that the incidence of adverse events including death, myocardial infarction, and revascularization. The mean follow-up period was 2.4 years. Results: We identified 112 HIV patients with 164 lesions undergoing PCI during the study period. Patients with HIV were more frequently male (n=88, 79%) and non-Caucasian (n=79, 71%) with a mean age of 57 years. The majority of patients were treated with DES (n=66, 59%). Most lesions displayed minimal calcification (67%), modest lesion length (16.6 mm±10.6) with a diameter stenosis of 69%, and an overall SYNTAX score of 13.5±8.9. The rate of all-cause mortality, MI or target vessel revascularization at 3 years was 29.5% while 19% of patients were readmitted due to cardiac causes (Figure 1). Similar results were obtained for both BMS and DES treated patients (29.8% vs 29.2%, P=0.95). ![Figure][1] Figure 1 Conclusion: Although the angiographic pattern of CAD in HIV patients suggests a relatively low-risk phenotype, the risk for adverse events after PCI, particularly revascularization, is significant. These findings suggest that atherosclerosis progression and restenosis is altered in the setting of HIV [1]: pending:yes