Coronary Artery Disease is a topic covered in the Johns Hopkins HIV Guide.

To view the entire topic, please or purchase a subscription.

Official website of the Johns Hopkins Antibiotic (ABX), HIV, Diabetes, and Psychiatry Guides, powered by Unbound Medicine. Johns Hopkins Guide App for iOS, iPhone, iPad, and Android included. Explore these free sample topics:

Johns Hopkins Guides

-- The first section of this topic is shown below --

PATHOGENS

  • HIV infection appears to increase coronary atherosclerosis and risk of acute coronary syndromes (ACS): 1.1 to 1.6x increased risk; 6-15% of deaths among HIV+ in U.S. and Europe caused by cardiovascular disease
    • Proposed mechanisms: HIV-mediated inflammation, coagulation disorders, lipid disturbances, gut translocation, and exposure to specific ART agents
  • ART agents associated with increased ACS risk (LPV/r, IDV, ABC, ddI) and increased cholesterol: greatest increase in cholesterol (>20mg/dL) with LPV/r, /r, NFV, TPV/r
    • Increased insulin resistance: most associated with LPV/r, IDV, d4T
    • Potential direct effect leading to ACS: ABC, ddI, LPV, IDV
  • Traditional risk factors:
    • Hypercholesterolemia and low HDL
    • Hypertension
    • Diabetes
    • Central obesity
    • Genetics (family history of MI < 55 yrs)
    • Advancing age
  • Behavioral factors
    • Smoking
    • Recreational drug use (especially cocaine)
    • Lack of exercise
    • Poor food choices

-- To view the remaining sections of this topic, please or purchase a subscription --

Last updated: January 5, 2017