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HIV and coronary artery disease

Joshua A Beckman, Meredith S Duncan, Charles W Alcorn, Kaku So-Armah, Adeel A Butt, Matthew B Goetz, Hilary A Tindle, Jason Sico, Russel P Tracy, Amy C Justice, Matthew S Freiberg
Background -The effect of HIV on the development of peripheral artery disease (PAD) remains unclear. We investigated whether HIV infection is associated with an increased risk of PAD after adjustment for traditional atherosclerotic risk factors in a large cohort of HIV infected (HIV+) and demographically similar HIV uninfected veterans. Methods -We studied participants in the Veterans Aging Cohort Study from April 1, 2003 through December 31, 2014. We excluded participants with known prior PAD or prevalent cardiovascular disease (myocardial infarction, stroke, coronary heart disease, and congestive heart failure) and analyzed the effect of HIV status on the risk of incident PAD events after adjusting for demographics, PAD risk factors, substance use, CD4 cell count, HIV-1 RNA, and antiretroviral therapy...
March 13, 2018: Circulation
Feliu Roset, Jesus M Ureña, Tiziana Cotrufo, José Carreras, Pablo Pérez de la Ossa, Fernando Climent
BACKGROUND Heart transplantation is a therapeutic option for patients with severe coronary artery disease or heart failure. One of the difficulties to overcome is the apoptosis of cardiomyocytes in the donor organ. To prevent apoptosis in the donor organ, we developed a fusion protein containing FLIP (FADD-like interleukin beta-converting enzyme (FLICE)-like inhibitory protein) to inhibit caspase-8. MATERIAL AND METHODS We linked the cDNA coding for the FLIP protein to the transduction domain of HIV (human immunodeficiency virus) to allow the protein to enter cells...
February 27, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Meredith E Clement, Li Lin, Ann Marie Navar, Nwora Lance Okeke, Susanna Naggie, Pamela S Douglas
Cardiovascular disease (CVD) is an increasing cause of morbidity and mortality in human immunodeficiency virus (HIV)-infected adults; however, this population may be less likely to receive interventions during hospitalization for acute coronary syndrome (ACS). The degree to which this disparity can be attributed to poorly controlled HIV infection is unknown.In this large cohort study, we used the National Inpatient Sample (NIS) to compare rates of cardiac procedures among patients with asymptomatic HIV-infection, symptomatic acquired immunodeficiency syndrome (AIDS), and uninfected adults hospitalized with ACS from 2009 to 2012...
February 2018: Medicine (Baltimore)
Martin Tibuakuu, Di Zhao, Ankita Saxena, Todd T Brown, Lisa P Jacobson, Frank J Palella, Mallory D Witt, Susan L Koletar, Joseph B Margolick, Eliseo Guallar, Sai Krishna C Korada, Matthew J Budoff, Wendy S Post, Erin D Michos
BACKGROUND: HIV-infected individuals are at increased risk for both sarcopenia and cardiovascular disease. Whether an association between low muscle mass and subclinical coronary artery disease (CAD) exists, and if it is modified by HIV serostatus, are unknown. METHODS: We performed cross-sectional analysis of 513 male MACS participants (72% HIV-infected) who underwent mid-thigh computed tomography (CT) and non-contrast cardiac CT for coronary artery calcium (CAC) during 2010-2013...
January 30, 2018: Journal of Cardiovascular Computed Tomography
Kenneth H Mayer, Stephanie Loo, Phillip M Crawford, Heidi M Crane, Michael Leo, Paul DenOuden, Magda Houlberg, Mark Schmidt, Thu Quach, Sebastian Ruhs, Meredith Vandermeer, Chris Grasso, Mary Ann McBurnie
OBJECTIVES: As the life expectancy of people infected with human immunodeficiency virus (HIV) infection has increased, the spectrum of illness has evolved. We evaluated whether people living with HIV accessing primary care in US community health centers had higher morbidity compared with HIV-uninfected patients receiving care at the same sites. METHODS: We compared data from electronic health records for 12 837 HIV-infected and 227 012 HIV-uninfected patients to evaluate the relative prevalence of diabetes mellitus, hypertension, chronic kidney disease, dyslipidemia, and malignancies by HIV serostatus...
January 1, 2017: Public Health Reports
Radosław Zwoliński, Juliusz Kamerys, Elżbieta Jabłonowska, Anna Marcinkiewicz, Ryszard Jaszewski, Radosław Kręcki, Bogdan Jegier
No abstract text is available yet for this article.
September 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
Thomas A Angelovich, Anna C Hearps, Anna Maisa, Theodoros Kelesidis, Anthony Jaworowski
Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide. Atherosclerosis, a leading cause of CAD, is initiated by the transmigration of innate immune monocytes to inflammatory sites of deposited lipid called fatty streaks, which are present in arterial walls of medium to large arteries. The key pathogenic feature of lesions at this early stage of atherosclerosis is the maturation of monocytes which migrate into arteries to form foam cells or lipid-laden macrophages. Considerable evidence supports the hypothesis that risk of atherosclerosis is increased by chronic inflammatory conditions accompanying diseases such as rheumatoid arthritis and HIV, as well as general ageing, and that this risk is predicted by monocyte activation...
October 17, 2017: Journal of Visualized Experiments: JoVE
Chris T Longenecker, Claire E Sullivan, Justin Morrison, Corrilynn O Hileman, David A Zidar, Robert Gilkeson, James O'Donnell, Grace A McComsey
OBJECTIVE: To determine the association of smoking and HIV status with tissue-specific inflammation measured by flurodeoxyglucose positron emission tomography (PET). DESIGN: A cross-sectional study. METHODS: We prospectively enrolled 55 HIV study participants on stable antiretroviral therapy and 19 age-matched HIV-uninfected controls without known cardiovascular disease. We measured aortic target-to-background ratio (TBR) and spleen standardized uptake values (SUV) 3-h post-FDG, and used regression models to examine the independent association of HIV and smoking status with PET variables...
January 2, 2018: AIDS
Moises A Huaman, Eduardo Ticona, Gustavo Miranda, Richard J Kryscio, Raquel Mugruza, Ernesto Aranda, Paola Rondan, David Henson, Cesar Ticona, Timothy R Sterling, Carl J Fichtenbaum, Beth A Garvy
Background: Tuberculosis has been associated with an increased risk of cardiovascular disease, including acute myocardial infarction (AMI). We investigated whether latent tuberculosis infection (LTBI) associates with AMI. Methods: We conducted a case-control study in two large national public hospital networks in Lima, Peru between July 2015 and March 2017. Cases were patients with a first time diagnosis of type 1 (spontaneous) AMI. Controls were patients without a history of AMI...
October 21, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Raquel de Vasconcellos Carvalhaes de Oliveira, Silvia Emiko Shimakura, Dayse Pereira Campos, Yara Hahr Marques Hökerberg, Flaviana Pavan Victoriano, Sayonara Ribeiro, Valdiléa G Veloso, Beatriz Grinsztejn, Marilia Sá Carvalho
The use of highly active antiretroviral therapy has resulted in changes of comorbidity profile in people living with HIV (PLHIV), increasing non-AIDS-related events. The occurrence of cardiovascular events is greater in PLHIV, but the mechanism responsible for it is still controversial. This article aimed to investigate factors associated with the progression to cardiovascular events in PLHIV using HAART. A 15-years cohort study with 1135 PLHIV was conducted in Rio de Janeiro-Brazil. Clinical progression was stratified in five states: No comorbidities (s1), arterial hypertension (s2), lipid abnormalities (s3), hypertension and lipid abnormalities (s4) and major cardiovascular events (stroke, coronary artery disease, thrombosis or death) (s5)...
October 23, 2017: AIDS Care
Ian R McNicholl, Monica Gandhi, C Bradley Hare, Meredith Greene, Edgar Pierluissi
OBJECTIVE: The goal of this pharmacist-led study was to utilize two validated instruments, Beers Criteria and Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (STOPP), to assess potentially inappropriate prescribing (PIP) in older patients infected with the human immunodeficiency virus (HIV) and evaluate pharmacist interventions. DESIGN: Prospective randomized interventional trial. SETTING: Large urban clinic providing interdisciplinary primary and HIV care for ~2700 HIV-positive publicly insured patients...
December 2017: Pharmacotherapy
Suman Srinivasa, Michael T Lu, Kathleen V Fitch, Travis R Hallett, Timothy K O'Malley, Lauren A Stone, Amanda Martin, Alexandra J Coromilas, Tricia H Burdo, Virginia A Triant, Janet Lo, Sara E Looby, Tomas G Neilan, Markella V Zanni
BACKGROUND: Mechanisms underlying the heightened myocardial infarction risk among HIV-infected women (versus non-HIV-infected women) remain unclear. Our objectives were to assess epicardial adipose tissue (EAT) volume and its associations among asymptomatic women with and without HIV. METHODS: Fifty-five HIV-infected and 27 non-HIV-infected women without known cardiovascular disease who underwent cardiac CT and metabolic/immune phenotyping were included. EAT volume derived from CT was compared among women with and without HIV, and within-group EAT associations were assessed...
September 20, 2017: Antiviral Therapy
Madeleine Durand, Carl Chartrand-Lefebvre, Jean-Guy Baril, Sylvie Trottier, Benoit Trottier, Marianne Harris, Sharon Walmsley, Brian Conway, Alexander Wong, Jean-Pierre Routy, Colin Kovacs, Paul A MacPherson, Kenneth Marc Monteith, Samer Mansour, George Thanassoulis, Michal Abrahamowicz, Zhitong Zhu, Christos Tsoukas, Petronela Ancuta, Nicole Bernard, Cécile L Tremblay
BACKGROUND: With potent antiretroviral drugs, HIV infection is becoming a chronic disease. Emergence of comorbidities, particularly cardiovascular disease (CVD) has become a leading concern for patients living with the infection. We hypothesized that the chronic and persistent inflammation and immune activation associated with HIV disease leads to accelerated aging, characterized by CVD. This will translate into higher incidence rates of CVD in HIV infected participants, when compared to HIV negative participants, after adjustment for traditional CVD risk factors...
September 11, 2017: BMC Infectious Diseases
Sai Krishna C Korada, Di Zhao, Martin Tibuakuu, Todd T Brown, Lisa P Jacobson, Eliseo Guallar, Robert K Bolan, Frank J Palella, Joseph B Margolick, Jeremy J Martinson, Matthew J Budoff, Wendy S Post, Erin D Michos
BACKGROUND AND AIMS: Frailty and cardiovascular disease share many risk factors. We evaluated whether frailty is independently associated with subclinical coronary atherosclerosis and whether any relationships differ by HIV-serostatus. METHODS: We studied 976 [62% HIV-infected] male participants of the Multicenter AIDS Cohort Study who underwent assessment of frailty and non-contrast cardiac CT scanning; of these, 747 men also underwent coronary CT angiography (CCTA)...
November 2017: Atherosclerosis
Ntobeko A B Ntusi, Mpiko Ntsekhe
The survival of patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) who have access to highly active antiretroviral therapy (ART) has dramatically increased in recent times. This review focuses on HIV-associated heart failure in sub-Saharan Africa (SSA). In HIV infected persons, heart failure may be related to pathology of the pericardium, the myocardium, the valves, the conduction system, or the coronary and pulmonary vasculature. HIV-associated heart failure can be because of direct consequences of HIV infection, autoimmune reactions, pro-inflammatory cytokines, opportunistic infections (OIs) or neoplasms, use of ART or therapy for OIs and presence of traditional cardiovascular risk factors...
September 2016: ESC Heart Failure
Andrew W McCrary, Chidozie U Nduka, Saverio Stranges, Gerald S Bloomfield
PURPOSE OF REVIEW: The current article addresses crucial issues in identifying risk of cardiovascular disease (CVD) in people living with HIV in low-income and middle-income countries (LMICs). These issues are in need of urgent attention to advance our knowledge and inform actions to mitigate CVD in this population. We address CVDs in adults living with HIV as well as the unique aspects pertaining to children living with HIV (CLHIV), a group sorely under-represented in this field. RECENT FINDINGS: CVDs affecting adults such as hypertension, dyslipidemia, coronary artery disease, and heart failure, in addition to myocardial dysfunction, vascular diseases, and autoimmune phenomena are also being reported in CLHIV...
August 10, 2017: Current Opinion in HIV and AIDS
Jonathan Buggey, Chris T Longenecker
PURPOSE OF REVIEW: The review aims to summarize the literature describing the clinical impact of cardiac fat depots in patients with HIV infection. RECENT FINDINGS: People living with HIV (PLHIV) have accelerated rates of cardiovascular disease, and are prone to the development of ectopic fat deposition. Specifically, PLHIV have higher volumes of epicardial and intracardiac fat quantified by noninvasive imaging. Higher volumes of epicardial fat may be related to antiretroviral therapy duration and chronic inflammation, independently of other measures of body adiposity such as BMI...
November 2017: Current Opinion in HIV and AIDS
Flavia Ballocca, Fabrizio D'Ascenzo, Sebastiano Gili, Walter Grosso Marra, Fiorenzo Gaita
With the progressive increase in life expectancy of HIV-positive patient, thanks to "highly active antiretroviral therapy" (HAART), new comorbidities, and especially cardiovascular diseases (CVDs) are emerging as an important concern. An increased risk of coronary artery disease, often in a younger age, has been observed in this population. The underlying pathophysiology is complex and partially still unclear, with the interaction of viral infection-and systemic inflammation-antiretroviral therapy and traditional risk factors...
November 2017: Trends in Cardiovascular Medicine
Matthew J Reilley, Anne Blair, William H Matthai, Rolando Vega, Meghan Buckley, Phyllis A Gimotty, Patrick F Fogarty
: Among adult patients with hemophilia A and hemophilia B the emergent management of acute coronary syndromes (ACSs) is challenging, and exposure to antithrombotic agents and/or revascularization procedures may confer an enhanced risk of bleeding. We sought to identify clinical characteristics and in-hospital outcomes among ACS patients with hemophilia A/hemophilia B, compared with matched noncoagulopathic ACS controls. Case discharges from the Nationwide Inpatient Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality (1998-2011) had International Classification of Diseases, 9th Revision codes for hemophilia A/hemophilia B and ACS...
December 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Ana Sofia Carvalho, Rui Osório Valente, Luís Almeida Morais, Pedro Modas Daniel, Ramiro Sá Carvalho, Lurdes Ferreira, Rui Cruz Ferreira
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)...
July 8, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
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