title: Quantitative angiographic characterisation of coronary artery disease in patients with human immunodeficiency virus (HIV) infection undergoing percutaneous coronary intervention.
abstract: OBJECTIVE
  Patients with human immunodeficiency virus (HIV) infection have an increased risk of acute myocardial infarction (MI), and 6.5-15% of mortality in this population is attributable to cardiovascular disease. However, the angiographic pattern of coronary artery disease (CAD) in patients with HIV undergoing percutaneous coronary intervention (PCI) remains unknown. We sought to assess and describe the angiographic features and burden of CAD in patients with HIV as compared to those without HIV infection.
  
  
  RESULTS
  This is a retrospective, single-centre study comparing 93 patients with HIV infection who underwent PCI between 2003 and 2011 with 93 control patients without HIV infection matched for age (±3 years), gender, diabetes, and year of PCI (±2 years). Quantitative coronary angiography (QCA) was performed for all treated lesions at baseline and following PCI in both groups. One-year clinical outcomes post PCI were also analysed and compared. The mean age for both study populations was 57 years; patients with HIV were more likely to present with ST-segment elevation myocardial infarction (STEMI). Patients had a similar extent of CAD as measured by the presence of multivessel disease as well as SYNTAX score; however, patients with HIV were more likely to have lesions in the proximal segment of the respective coronary artery. While both groups mostly displayed none/mild calcified lesions, HIV+ patients had longer and fewer stenotic lesions. Clinical outcomes at one year were similar.
  
  
  CONCLUSIONS
  While HIV+ patients were more likely to present with STEMI, detailed coronary angiographic analysis revealed less complex lesions and favourable anatomy. This paradox may suggest alterations in genesis and progression of atherosclerosis in this clinical setting.
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Kleanthis
authors.initials: K
authors.lastname: Theodoropoulos
authors.forename: Marco G
authors.initials: MG
authors.lastname: Mennuni
authors.forename: Samantha
authors.initials: S
authors.lastname: Sartori
authors.forename: Omar A
authors.initials: OA
authors.lastname: Meelu
authors.forename: Jennifer
authors.initials: J
authors.lastname: Yu
authors.forename: Usman
authors.initials: U
authors.lastname: Baber
authors.forename: Giulio G
authors.initials: GG
authors.lastname: Stefanini
authors.forename: Ioannis
authors.initials: I
authors.lastname: Mastoris
authors.forename: Pedro
authors.initials: P
authors.lastname: Moreno
authors.forename: George D
authors.initials: GD
authors.lastname: Dangas
authors.forename: Roxana
authors.initials: R
authors.lastname: Mehran
authors.forename: Samin K
authors.initials: SK
authors.lastname: Sharma
authors.forename: Annapoorna S
authors.initials: AS
authors.lastname: Kini
mesh_terms: D000328:Adult; D000368:Aged; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery* / Q000821:virology*; D003331:Coronary Vessels / Q000601:surgery; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000379:methods; D012189:Retrospective Studies