Coronary Artery Disease
- HIV infection increases coronary atherosclerosis and risk of acute coronary syndromes (ACS): 1-2x increased risk; 6-15% of deaths among HIV+ in U.S. and Europe caused by cardiovascular disease
- Proposed mechanisms: HIV-mediated inflammation, immune activation, immune dysregulation (abnorml CD4:CD8 ratio), coagulation disorders, lipid disturbances, gut translocation, and exposure to specific ART agents
- ART substantially reduces CVD risk, but does not neutralize the risk for all people living with HIV.
- ART agents in the past have had a contribution to CVD risk (LPV/r, IDV, ABC, ddI). Current agents (except possibly for ABC) are not directly associated with CVD risk.
- Traditional risk factors:
- Hypercholesterolemia and low HDL
- Central obesity
- Genetics (family history of MI < 55 yrs)
- Advancing age
- Behavioral factors
- Recreational drug use (especially cocaine)
- Lack of exercise
- Poor food choices
There's more to see -- the rest of this topic is available only to subscribers.
Last updated: March 4, 2023
Hoffmann, Christopher J. "Coronary Artery Disease." Johns Hopkins HIV Guide, 2023. Johns Hopkins Guides, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545238/all/Coronary_Artery_Disease.
Hoffmann CJ. Coronary Artery Disease. Johns Hopkins HIV Guide. 2023. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545238/all/Coronary_Artery_Disease. Accessed June 9, 2023.
Hoffmann, C. J. (2023). Coronary Artery Disease. In Johns Hopkins HIV Guide https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545238/all/Coronary_Artery_Disease
Hoffmann CJ. Coronary Artery Disease [Internet]. In: Johns Hopkins HIV Guide. ; 2023. [cited 2023 June 09]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545238/all/Coronary_Artery_Disease.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Coronary Artery Disease ID - 545238 A1 - Hoffmann,Christopher,M.D., M.P.H. Y1 - 2023/03/04/ BT - Johns Hopkins HIV Guide UR - https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545238/all/Coronary_Artery_Disease DB - Johns Hopkins Guides DP - Unbound Medicine ER -