811 
Clinical and Angiographic Features of Acute Coronary Syndromes in HIV-infected Compared with Non-HIV-infected Patients
F Boccara1, M Mary-Krause2, E Teiger1, S Lang1, P Lim1, K Wahbi1, J Collet1, F Beygui1, Dominique Costagliola*2, A Cohen1, and Sponsored by the French National Agency for Research on AIDS and Viral Hepatitis
1Univ Paris V, VI, XII, Paris, France and 2INSERM UMR S720, Paris, France
Background: Acute coronary syndrome (ACS) is an emerging
complication in HIV-infected patients under HAART, but specific characteristics
of ACS in HIV-infected patients remain unknown.
Methods: Between September 2003 and March 2006, we
enrolled prospectively 104 HIV+ patients and 184 controls (HIV)
admitted for ACS matched for age (±5 years), gender, and type of ACS in 20
different intensive care cardiolgy units.
Results: The mean age of patients was 48.7±9.1 years, and 92.7%
were men. Baseline clinical and angiographic characteristics are shown in the table.
The most frequent type of ACS was ST segment elevation myocardial infarction
(52.1%), then unstable angina (26.1%) and non-ST segment elevation myocardial
infarction (21.5%). At admission, Killip class 2 or more was more frequent in
HIV+ than HIV participants (8.9% vs
3.4%, p = 0.049). However, left
ventricular ejection fraction was similar in both groups (54.2% vs 54.5%, p = 0.79). Percutaneous
coronary intervention was performed less frequently in HIV+ than HIV
(72.6% vs 86.3%, p
= 0.005) as the use of GPIIbIIIa (31.7% vs 45.1%, p = 0.026), but with the same procedural immediate success rate
achieved (97%) and rate of stenting (96%). The rate of bare metal and drug-eluting
stents implanted was similar in both groups (63% vs
64%, p = 0.5 and 37% vs 36%, p = 0.9, respectively).
Conclusions: HIV-infected patients did not differ from
non-HIV-infected patients regarding baseline clinical and angiogaphic
characteristics during a first episode of ACS. Follow-up of this observational
prospective study will continue during 3 years.
|
|
HIV+
n=104
|
HIV
n=184
|
p
|
|
Diabetes no. (%)
|
9 (8.8)
|
19 (10.4)
|
0.66
|
|
Hypertension no. (%)
|
20 (19.6)
|
47 (25.7)
|
0.25
|
|
Current smoker no. (%)
|
81 (80.2)
|
149 (84.2)
|
0.40
|
|
Hypercholesterolemia no. (%)
|
47 (35.8)
|
72 (39.4)
|
0.27
|
|
Hypertriglyceridemia no. (%)
|
42 (41.6)
|
36 (20.1)
|
0.0001
|
|
Family history of coronary artery disease no. (%)
|
20 (19.6)
|
51 (27.9)
|
0.12
|
|
Statins used before ACS no.
(%)
|
10 (9.6)
|
24 (13)
|
0.39
|
|
Extent of coronary artery disease
|
|
|
|
|
1 vessel
no. (%)
|
55 (52.9)
|
111 (60.3)
|
0.16
|
|
2 vessels no. (%)
|
24 (23.1)
|
43 (23.4)
|
0.16
|
|
Culprit-related vessel
|
|
|
|
|
3 vessels no. (%)
|
9 (8.7)
|
17 (9.2)
|
0.16
|
|
Left anterior descending artery no. (%)
|
39 (37.5)
|
66 (35.9)
|
0.20
|
|
Right coronary artery no. (%)
|
26 (25)
|
61 (3.2)
|
0.15
|
|
Left circumflex no. (%)
|
12 (11.5)
|
22 (12)
|
0.9
|
Baseline
clinical and angiographic characteristics
|
