Outcome of Coronary Heart Disease in HIV-Infected Subjects
Few data have been published on the outcome of acute coronary events among HIV- infected patients compared to HIV-seronegative subjects. Compared with HIV-seronegative patients with idiopathic dilated cardiomyopathy, HIV-infected counterparts had markedly reduced survival and a hazards ratio for death of 4.0 [49].
A study of 24 HIV- seropositive subjects with acute MI [50] showed that characteristics at hospital admission, the treatment strategy, and the relatively benign in-hospital outcome were similar to those of HIV-seronegative subjects admitted for acute MI. In contrast, after 15 months of follow-up, a higher incidence of recurrent infarction was observed among HIV-infected patients (20% vs. 4%, p=0.07), together with a higher incidence of hospitalization for other recurrent coronary events (45% vs. 11%, p=0.007). Although the TIMI risk scores of HIV-infected patients with acute coronary syndromes (ACS) are lower and these patients have less extensive coronary disease than HIV-seronegative patients with ACS, percutaneous coronary intervention in HIV- infected patients is associated with high restenosis rates [51]. Further studies are necessary to confirm this worse long-term prognosis of HIV-seropositive subjects with CHD.
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