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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Acute coronary syndromes in treatment-naïve black south africans with human immunodeficiency virus infection
Journal of Interventional Cardiology, Volume 23, No. 1, Year 2010
Notification
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Description
Background: HIV patients on protease inhibitors have greater risk of acute coronary syndromes (ACS) but little is known about treatment-naïve patients. Methods and Results: Authors conducted a prospective single-center study from Soweto, South Africa, comparing the clinical and angiographic features of treatment-naïve HIV positive and negative patients with ACS. Between March 2004 and February 2008, 30 consecutive treatment-naïve HIV patients with ACS were compared to the next HIV-negative patient as a 1:1 control. HIV patients were younger (43 ± 7 vs. 54 ± 13, P = 0.004) and, besides smoking (73% vs. 33%, P = 0.002), had fewer risk factors than the control group with less hypertension (23% vs. 77%, P = 0.0001), diabetes (3% vs. 23%, P = 0.05), LDL hyperlipidemia (2.2 ± 0.9 vs. 3.0 ± 1.2, P = 0.006), and other coronary risk factors (7% vs. 53%, P = 0.0001). HDL was lower in the HIV group (0.8 ± 0.3 vs. 1.1 ± 0.4, P = 0.001). Atherosclerotic burden was lower in the HIV group with more normal infarct-related arteries (47% vs. 13%, P = 0.005) but a higher degree of large thrombus burden (43% vs. 17%, P = 0.02). Stents were used to a similar degree in HIV and control patients (30% vs. 37%, P = 0.78) with more target lesion revascularization in the HIV group (56% vs. 0%, P = 0.008). Conclusion: Treatment-naïve HIV patients with ACS are younger and have fewer traditional risk factors than HIV-negative patients. HIV patients have less atherosclerotic but higher thrombotic burden which may imply a prothrombotic state in the pathogenesis of ACS in these patients. © 2009, Wiley Periodicals, Inc.
Authors & Co-Authors
Becker, Anthony C.
South Africa, Johannesburg
Chris Hani Baragwanath Hospital
Sliwa, Karen S.
South Africa, Johannesburg
Chris Hani Baragwanath Hospital
Stewart, Simon D.
South Africa, Johannesburg
Chris Hani Baragwanath Hospital
Australia, Melbourne
Baker Heart and Diabetes Institute
Libhaber, Elena N.
South Africa, Johannesburg
Chris Hani Baragwanath Hospital
Zambakides, Christos A.
South Africa, Johannesburg
Chris Hani Baragwanath Hospital
Essop, Mohammed Rafique
South Africa, Johannesburg
Chris Hani Baragwanath Hospital
Statistics
Citations: 50
Authors: 6
Affiliations: 2
Identifiers
Doi:
10.1111/j.1540-8183.2009.00520.x
ISSN:
08964327
e-ISSN:
15408183
Research Areas
Health System And Policy
Infectious Diseases
Noncommunicable Diseases
Study Design
Randomised Control Trial
Cohort Study
Study Locations
South Africa