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HIV and Coronary Disease - When Secondary Prevention Is Insufficient

dc.contributor.authorCarvalho, AS
dc.contributor.authorOsório Valente, R
dc.contributor.authorAlmeida-Morais, L
dc.contributor.authorDaniel, P
dc.contributor.authorSá Carvalho, R
dc.contributor.authorFerreira, L
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2017-08-24T15:43:56Z
dc.date.available2017-08-24T15:43:56Z
dc.date.issued2017
dc.description.abstractHighly active antiretroviral therapy (HAART) has created a new paradigm for human immunodeficiency virus (HIV)-infected patients, but their increased risk for coronary disease is well documented. We present the case of a 57-year-old man, co-infected with HIV-2 and hepatitis B virus, adequately controlled and with insulin-treated type 2 diabetes and dyslipidemia, who was admitted with non-ST elevation acute myocardial infarction. Coronary angiography performed on day four of hospital stay documented two-vessel disease (mid segment of the right coronary artery [RCA, 90% stenosis] and the first marginal). Two drug-eluting stents were successfully implanted. The patient was discharged under dual antiplatelet therapy (aspirin 100 mg/day and clopidogrel 75 mg/day) and standard coronary artery disease medication. He was admitted to the emergency room four hours after discharge with chest pain radiating to the left arm and inferior ST-segment elevation myocardial infarction was diagnosed. Coronary angiography was performed within one hour and documented thrombosis of both stents. Optical coherence tomography revealed good apposition of the stent in the RCA, with intrastent thrombus. Angioplasty was performed, with a good outcome. The acute stent thrombosis might be explained by the thrombotic potential of HIV infection and diabetes. There are no specific guidelines regarding HAART in secondary prevention of acute coronary syndromes. A multidisciplinary approach is essential for optimal management of these patients.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Port Cardiol. 2017 Jul - Aug;36(7-8):569.e1-569.e8pt_PT
dc.identifier.doi10.1016/j.repc.2016.10.009pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2741
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevier Españapt_PT
dc.subjectHSM CARpt_PT
dc.subjectAntiretroviral Therapy, Highly Activept_PT
dc.subjectCoronary Thrombosis/etiologypt_PT
dc.subjectCoronary Thrombosis/prevention & controlpt_PT
dc.subjectHIV Infections/complications
dc.subjectHIV Infections/drug therapy
dc.subjectPostoperative Complications/etiology
dc.subjectPostoperative Complications/prevention & control
dc.subjectSecondary Prevention
dc.subjectStents
dc.titleHIV and Coronary Disease - When Secondary Prevention Is Insufficientpt_PT
dc.title.alternativeVIH e Doença Coronária - Quando a Prevenção Secundária É Insuficientept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage569.e8pt_PT
oaire.citation.issue7-8pt_PT
oaire.citation.startPage569.e1pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologia (English Edition)pt_PT
oaire.citation.volume36pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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