Progression of coronary artery disease in a HIV-infected patient previously treated for ascending aorta aneurysm

HIV-Positive Patient With Non-Percutaneous Coronary Intervention (PCI)-Amenable Left Coronary Artery Aneurysms Presenting With ST-Elevation Myocardial Infarction (STEMI)

“…With time, a wide array of antiretroviral medications are now available, with the first HIV antiviral medication being azidothymidine (AZT), a nucleoside reverse transcriptase inhibitor (NRTI), which blocks RNA-dependent DNA polymerase preventing DNA replication via reverse transcriptase [1][2][3]. With the vast antiviral medications on the market, an HIV-positive individual's life expectancy has dramatically increased, and the myriad of HIV-related cardiac, pulmonary, infectious, renal, and psychiatric complications have dramatically decreased [2][3][4]. Due to the reduction in AIDS-related mortality with potent antiretrovirals, non-HIV-related mortality including cardiovascular mortality has become increasingly relevant.…”

“…HIV is a pro-inflammatory, pro-thrombotic, and dyslipidemic state as evidenced by low CD4/high CD8, low protein S, and low apolipoprotein B/elevated LDL-cholesterols, respectively. These in turn lead to inflammation and more importantly myocardial infarctions (MI) [3][4][5][6]. This is why HIV infection is considered a risk enhancer in the primary prevention cholesterol guidelines according to the American College of Cardiology (ACC) [7][8].…”