| Title: |
HIV and coronary disease – When secondary prevention is insufficient |
| Authors: |
Ana Sofia Carvalho; Rui Osório Valente; Luís Almeida Morais; Pedro Modas Daniel; Ramiro Sá Carvalho; Lurdes Ferreira; Rui Cruz Ferreira |
| Source: |
Revista Portuguesa de Cardiologia (English Edition), Vol 36, Iss 7, Pp 569.e1-569.e8 (2017) |
| Publisher Information: |
Elsevier |
| Publication Year: |
2017 |
| Collection: |
Directory of Open Access Journals: DOAJ Articles |
| Subject Terms: |
Diseases of the circulatory (Cardiovascular) system; RC666-701 |
| Description: |
Highly active antiretroviral therapy (HAART) has created a new paradigm for human immunodeficiency virus (HIV)-infected patients, but their increased risk for coronary disease is well documented.We present the case of a 57-year-old man, co-infected with HIV-2 and hepatitis B virus, adequately controlled and with insulin-treated type 2 diabetes and dyslipidemia, who was admitted with non-ST elevation acute myocardial infarction. Coronary angiography performed on day four of hospital stay documented two-vessel disease (mid segment of the right coronary artery [RCA, 90% stenosis] and the first marginal). Two drug-eluting stents were successfully implanted. The patient was discharged under dual antiplatelet therapy (aspirin 100 mg/day and clopidogrel 75 mg/day) and standard coronary artery disease medication. He was admitted to the emergency room four hours after discharge with chest pain radiating to the left arm and inferior ST-segment elevation myocardial infarction was diagnosed. Coronary angiography was performed within one hour and documented thrombosis of both stents. Optical coherence tomography revealed good apposition of the stent in the RCA, with intrastent thrombus. Angioplasty was performed, with a good outcome.The acute stent thrombosis might be explained by the thrombotic potential of HIV infection and diabetes. There are no specific guidelines regarding HAART in secondary prevention of acute coronary syndromes. A multidisciplinary approach is essential for optimal management of these patients. Resumo: A terapêutica antiretroviral (TARV) alterou o paradigma da infeção pelo vírus da imunodeficiência humana (VIH), conhecendo-se o risco aumentado de doença coronária nestes doentes.Apresenta-se o caso de um homem de 57 anos, melanodérmico, com coinfecção VIH-2/vírus hepatite B, com controlo adequado; diabetes mellitus tipo 2, insulino-tratado e dislipidemia. Internado por enfarte agudo do miocárdio, sem supradesnivelamento ST. Realizou cateterismo ao 4.° dia de internamento, documentando-se doença de dois ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
http://www.sciencedirect.com/science/article/pii/S2174204917301629; https://doaj.org/toc/2174-2049; https://doaj.org/article/7c059e9a797e483e9a7c60a39ebaf05d |
| DOI: |
10.1016/j.repce.2016.10.019 |
| Availability: |
https://doi.org/10.1016/j.repce.2016.10.019; https://doaj.org/article/7c059e9a797e483e9a7c60a39ebaf05d |
| Accession Number: |
edsbas.D32A01B8 |
| Database: |
BASE |