Looking Forward

Given the advent of newer antiretroviral agents, more patients with HIV are living longer and AIDS-related deaths are declining. However, CVD-related deaths have increased. In addition, current data suggest that CHD can be similarly managed in patients with HIV and patients without HIV.

“Both HIV and CHD are global health issues, and as the HIV population ages, the increase in cardiovascular risk will pose future challenges to clinicians and health authorities,” the researchers wrote.1 In particular, they urged more research be directed toward developing nations, especially in light of the higher disease burden and fewer healthcare and monetary resources available.1


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“[M]ore investigation and study are required to understand the critical pathways in the pathogenesis of the atherosclerotic process in the HIV population, the role of aggressive primary and secondary preventative measures for CHD, and the role of current and newer antiretroviral therapies.”1

References

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  2. Manga P, McCutcheon K, Tsabedze N, Vachiat A, Zachariah D. HIV and nonischemic heart disease. J Am Coll Cardiol. 2017;69(1):83-91. doi:10.1016/j.jacc.2016.09.977
  3. Zuber JP, Calmy A, Evison JM, et al; for the Swiss HIV Cohort Study Group. Pulmonary arterial hypertension related to HIV infection: improved hemodynamics and survival associated with antiretroviral therapy. Clin Infect Dis. 2004;38:1178-1185.
  4. Opravil M, Pechère M, Speich R, et al; for the Swiss HIV Cohort study. HIV-associated primary pulmonary hypertension: a case control study. Am J Respir Crit Care Med. 1997;155:990-995.
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  7. Tseng ZH, Secemsky EA, Dowdy D, et al. Sudden cardiac death in patients with human immunodeficiency virus infection. J Am Coll Cardiol. 2012;59:1891-1896.
  8. Hsu JC, Li Y, Marcus GM, et al. Atrial fibrillation and atrial flutter in human immunodeficiency virus-infected persons: incidence, risk factors, and association with markers of HIV disease severity. J Am Coll Cardiol. 2013;61:2288-2295.
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  12. Paisible AL, Chang CC, So-Armah KA, et al. HIV infection, cardiovascular disease risk factor profile, and risk for acute myocardial infarction. J Acquir Immune Defic Syndr. 2015;68:209-216.
  13. Kuller LH, Tracy R, Belloso W, et al; for the INSIGHT SMART Study Group. Inflammatory and coagulation biomarkers and mortality in patients with HIV infection. PLoS Med. 2008;5:e203.
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  16. Law MG, Friis-Moller N, El-Sadr WM, et al; for the D:A:D Study Group. The use of the Framingham equation to predict myocardial infarctions in HIV-infected patients: comparison with observed events in the D:A:D study. HIV Med. 2006;7:218-230.
  17. Mooney S, Tracy R, Osler T, et al. Elevated biomarkers of inflammation and coagulation in patients with HIV are associated with higher Framingham and VACS risk index scores. PLoS One. 2015;10:e0144312.
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  23. Manga P. HIV and heart disease in Africa. J Am Coll Cardiol. 2015;66:586-588.
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  26. Ren X, Trilesskaya M, Kwan DM, et al. Comparison of outcomes using bare metal vs drug-eluting stents in coronary artery disease patients with and without human immunodeficiency virus infection. Am J Cardiol. 2009;104:216-222.
  27. D’Ascenzo F, Cerrato E, Appleton D, et al; for the Percutaneous Coronary Intervention and Surgical Revascularization in HIV Database (PHD) Study Investigators. Prognostic indicators for recurrent thrombotic events in HIV-infected patients with acute coronary syndromes: use of registry data from 12 sites in Europe, South Africa, and the United States. Thromb Res. 2014;134:558-564.
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