HIV and the Heart: Difference between revisions

HIV and the Heart (view source)

Revision as of 19:41, 27 March 2013

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→‎Clinical presentation and revascularization

Drj

Bureaucrats, Administrators

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 Clinical outcome after revascularization (predominantly for ACS) is similar for HIV-infected and non-infected populations, regardless of whether revascularization is performed percutaneously or surgically.<cite>55</cite><cite>56</cite> HIV-infected patients, however, do remain at increased risk for recurrent ACS during follow-up<cite>57</cite>, which is importantly associated with persistently elevated lipid spectra.
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-!Key Points:
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-*Patients with human immunodeficiency virus infection are at increased risk for cardiovascular disease compared with the general non-infected population.
-*The increased risk originates from an increased pertinence of traditional risk factors for cardiovascular disease, in combination with the detrimental effects of the HIV-infection itself and the adverse (combined) antiretroviral therapy drug effects.
-*Prevention of cardiovascular disease in HIV-positive patients should in particular focus on prevention of dyslipidemia, and smoking, which are both common in HIV-infected patients, and represent important (modifiable) determinants of the cardiovascular disease risk in these patients.
-*Drug interactions in patients treated with (combined) antiretroviral therapy are frequent, especially between antiretroviral therapy and statins or antiplatelet agents such as prasugrel and ticagrelor, which occurs predominantly through the cytochrome P450 pathway.
-*The increased risk for cardiovascular disease predominantly results in an early occurrence of acute myocardial infarction, for which coronary revascularization is associated with good outcome, although recurrent ischemic events are more common in HIV-infected patients than in the general non-infected population.
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 ==References==