Background: Human immunodeficiency virus infection leads to a variety of Cardiovascular manifestations. Pericardial effusion, systemic hypertension, dilated cardiomyopathy, coronary artery disease, pulmonary hypertension, primary as well as secondary cardiac tumours etc are seen in about 30% of patients and the incidence has increased with improved longevity. Coronary artery disease ranging from subclinical atherosclerosis to coronary plaque rupture causing acute coronary syndrome have been documented. The main underlying pathophysiological process is a state of perennial inflammation which leads to initiation and acceleration of coronary atherosclerosis.
Objective: To study the coronary angiographic profile in HIV patients.
Methodology: HIV patients undergoing coronary angiography were assessed clinically, biochemically and finally by coronary angiography to see the coronary pathoanatomy.
Results: Of the 37 HIV patients studied between Jan to Dec 2019, the mean age was 47 years.(19-66 years). Two thirds were males; most common traditional risk factor was dyslipidemia followed by hypertension. Most patients were already on ART and the CD 4 counts ranged from 67-366cells/cumm. Anterior wall MI and unstable angina were the most common clinical presentations. Coronary angiography revealed diffuse disease (both insignificant and significant) of the left anterior descending artery as the most common pattern of angiographic involvement.
Conclusion: Coronary artery disease both subclinical and syndromic occurs with increased frequency in HIV patients. The dominant angiographic presentation correlates with the clinical presentation and in our study, left anterior descending artery was more frequently diseased as compared to other coronaries. The most common coronary angiographic pattern was the presence of ectasia and diffuse disease.
Keywords: Human immunodeficiency virus, cardiovascular manifestations, coronary artery disease, coronary angiography.
Rapid progression of atherosclerotic coronary artery disease in patients with human immunodeficiency virus infection