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Acute myocardial infarction (AMI) in a patient with Human Immunodeficiency Virus infection

Abstract

Introduction: Recent studies have shown that in HIV patients, the incidence of acute myocardial infarction is up to two times higher than in people who are not infected with HIV. HIV patients presenting with the first episode of the acute coronary syndrome are, on average, a decade younger than the general population, more frequently in men and current smokers.

Case Report: We report a case report of a 33-year-old man with a diagnosis of anteroseptal STEMI and recent HIV on first-line ART, a combination of zidovudine 300 mg and lamivudine 150 mg, plus efavirenz 600 mg. The patient had typical angina complaints and had risk factors, namely smoking and a history of dyslipidemia. Patients were treated according to acute coronary syndrome guidelines, given DAPT, heparinization for five days, statins, anti-ischemia, ACE-I, and DCA-PCI. The DCA-PCI result in this patient was CAD 1 VD with 1 DES installed in the proximal LAD (complete revascularization). The patient was discharged from the hospital after seven days of treatment. Prognosis in these patients is still quite good, but preventing recurrent myocardial infarction needs risk factors and control for successful myocardial infarction therapy and ART.

Conclusion: Special attention should be given to the risk of myocardial in HIV patients. Early diagnosis and prompt treatment could significantly lower mortality and improve patients' quality of life.

References

  1. Frieberg MS, Chang CCH, Kuller LH, Skanderson M, Lowy E, Kraemer KL, et al. HIV infection and the risk of acute myocardial infarction. JAMA Intern Med. 2013;173:614–22.
  2. Triant VA. HIV Infection and coronary heart disease: an intersection of epidemics. J Infect Dis. 2012;205:355–61.
  3. Durand M, Sheehy O, Baril JG, Lelorier J, Tremblay CL. Association between HIV infection, antiretroviral therapy, and risk of acute myocardial infarction: a cohort and nested case-control study using Quebec's public health insurance database. J Acquir Immune Defic Syndr. 2011;57:245–53.
  4. Paisable AL, Chang CC, So-Armah KA, et al. HIV infection, cardiovascular disease risk factor profile, and risk for acute myocardial infarction. J Acquir Immune Defic Syndr. 2015;68:209–16.
  5. Vachiat A, McCutcheon K, Tsabedze N, Zachariah D, Manga P. HIV and Ischemic Heart Disease. JACC. 2017;69(1):73-82.
  6. Drozd DR, Kitahata MM, Althoff KN, et al. Increased Risk of Myocardial Infarction in HIV-Infected Individuals in North America Compared With the General Population. J Acquir Immune Defic Syndr. 2017;75:568-76.
  7. Kearns A, Gordon J, Burdo TH, Qin X. HIV-1–Associated Atherosclerosis. JACC. 2017;69(25):3083-98.
  8. Boccara F, Mary-Krause M, Teiger E, et al. Acute coronary syndrome in human immunodeficiency virus-infected patients: characteristics and 1 year prognosis. Eur Heart J. 2011;32:41–50.
  9. Smith CJ, Ryom L, Weber R. Trends in underlying causes of death in people with HIV from 1999 to 2011: a multicohort collaboration. Lancet. 2014;384:241–8.
  10. Kupková P, Heczko M, Kaučák V, Kryza R. HIV as a risk factor of coronary artery disease and of acute coronary syndrome: A review and case series. CRVASA. 2016;443:1-4.
  11. Triant VA, Meigs JB, Grinspoon SK. Association of C-reactive protein and HIV infection with acute myocardial infarction. J Acquir Immune Defic Syndr. 2009;51:268–73.
  12. Kuller LH, Tracy R, Belloso W. Inflammatory and coagulation biomarkers and mortality in patients with HIV infection. Plos Med. 2008;5:e203.
  13. So-Armah K, Freiberg MS. Cardiovascular disease risk in an aging HIV population: not just a question of biology. Curr Opin HIV AIDS. 2014;9:346-54.
  14. Lang S, Boccara F, Mary-Krause M. Epidemiology of coronary heart disease in HIVinfected versus uninfected individuals in developed countries. Arch Cardiovasc Dis. 2015;108:206–15.
  15. Borissoff JI, Cate HT. From neutrophil extracellular traps release to thrombosis: an overshooting host-defense mechanism? J Thromb Haemost. 2011;9:1791–4.
  16. Graham SM, Rajwans N, Jaoko W. Endothelial activation biomarkers increase after HIV-1 acquisition: plasma vascular cell adhesion molecule-1 predicts disease progression. AIDS. 2013;27:1803–13.
  17. Boccara F, Lang S, Meuleman C. HIV and coronary heart disease: time for a better understanding. J Am Coll Cardiol. 2013;61:511–23.
  18. Ford ES, Greenwald JH, Richterman AG. Traditional risk factors and D dimer predict incident cardiovascular disease events in chronic HIV infection. AIDS. 2010;24:1509–17.
  19. Becker AC, Libhaber E, Sliwa K. Antiphospholipid antibodies in black South Africans with HIV and acute coronary syndromes: prevalence and clinical correlates. BMC Res Notes. 2011;4:379.
  20. Chastain DB, Henderson H, Stover KR. Epidemiology and Management of Antiretroviral-Associated Cardiovascular Disease. The Open AIDS Journal. 2015;9:23-37.
  21. Martin A, Bloch M, Armin J, et al. STEAL Study Group. Simplification of antiretroviral therapy with tenofovir-emtricitabine or abacavir-lamivudine: a randomized, 96-week trial. Clin Infect Dis. 2009:49(10);1591-601.
  22. Crane HM, Grunfeld C, Willig JH, et al. Impact of NRTIs on lipid levels among a large HIV-infected cohort initiating antiretroviral therapy in clinical care. AIDS. 2011;25(2):185-95.
  23. So-Armah K, Freiberg MS. Cardiovascular disease risk in an aging HIV population: not just a question of biology. Curr Opin HIV AIDS. 2014;9:346-54.
  24. Thienemann F, Sliwa K, Rockstroh JK. HIV and the heart: the impact of antiretroviral therapy: a global perspective. European Heart Journal. 2013:34;3538–46.
  25. Seecheranb VK, Giddingsa SL, Seecheran NA. Acute coronary syndromes in patients with HIV. Coron Artery Dis. 2017;28:166–72.
  26. Giguère P, Nhean S, Tseng AL, Hughes CA, Angel JB. Getting to the Heart of the Matter: A Review of Drug Interactions Between HIV Antiretrovirals and Cardiology Medications. Canadian Journal of Cardiology. 2019;35:326-40.

How to Cite

Rampengan, S. H., & Untu, V. B. F. P. . (2022). Acute myocardial infarction (AMI) in a patient with Human Immunodeficiency Virus infection. Bali Medical Journal, 11(2), 619–627. https://doi.org/10.15562/bmj.v11i2.3569

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Starry Homenta Rampengan
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Victor Billy F. Putra Untu
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