title: Clinical presentation of acute coronary syndrome in HIV infected adults: a retrospective analysis of a prospectively collected cohort.
abstract: OBJECTIVE
  To compare clinical presentation and short-term prognosis of acute coronary syndrome (ACS) in HIV-infected and uninfected adults.
  
  
  METHODS
  Retrospective analysis of a prospectively collected cohort.
  
  
  METHODS
  HIV-infected patients with myocardial infarction or unstable angina were identified by clinical history and specific characteristics of HIV infection were consecutively registered. Surviving patients were followed for at least one month after discharge. Risk factors for cardiovascular disease, clinical symptoms at admission, type of ACS, delivery of care, and factors associated with prognosis were compared between HIV-infected and uninfected adults.
  
  
  RESULTS
  Among 627 patients included, 44 (7%) were HIV-infected patients. HIV-infected patients were younger, more frequently men, and had higher prevalence of cardiovascular risk factors than uninfected patients. HIV-infected patients persisted frequently with less pain at Emergency Department (ED) (34% vs 82%, P<0.001) and complained of dyspnea (2% vs 15%, P<0.05) persisted in respect to HIV-uninfected patients. ST-elevation myocardial infarction was the most frequent ACS in HIV-infected patients (59% vs 24%) whereas non-ST-elevation myocardial infarction (23% vs 38%) and unstable angina (18% vs 38%) were the predominant ones in uninfected patients (P<0.001). Catheterism was performed more commonly in HIV-infected patients (75% vs 62%, P<0.01) and similarly admitted in the coronary care unit (38% vs 41%, P=0.81). The evolution was similar in both groups. When HIV-infected patients were matched by age and sex with a subgroup of 88 HIV-uninfected patients, most of the differences disappeared.
  
  
  CONCLUSIONS
  HIV-infected adults presenting with ACS are younger and have fewer symptoms than uninfected. Despite having a more established disease, short-term prognosis is similar.
authors.affiliation: Emergency Department, Barcelona, Spain. rperello@clinic.ub.es
authors.forename: R
authors.initials: R
authors.lastname: Perelló
authors.forename: M
authors.initials: M
authors.lastname: Calvo
authors.forename: O
authors.initials: O
authors.lastname: Miró
authors.forename: M
authors.initials: M
authors.lastname: Castañeda
authors.forename: N
authors.initials: N
authors.lastname: Saubí
authors.forename: S
authors.initials: S
authors.lastname: Camón
authors.forename: A
authors.initials: A
authors.lastname: Foix
authors.forename: J M
authors.initials: JM
authors.lastname: Gatell
authors.forename: M
authors.initials: M
authors.lastname: Masotti
authors.forename: J
authors.initials: J
authors.lastname: Mallolas
authors.forename: M
authors.initials: M
authors.lastname: Sánchez
authors.forename: E
authors.initials: E
authors.lastname: Martinez
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012367:RNA, Viral / Q000032:analysis*; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
chemical_list: D012367:RNA, Viral