{"id":7704,"date":"2005-01-31T08:38:33","date_gmt":"2005-01-31T08:38:33","guid":{"rendered":"http:\/\/moomango.co.uk\/htb\/?p=7704"},"modified":"2014-05-22T15:11:09","modified_gmt":"2014-05-22T15:11:09","slug":"coronary-artery-bypass-graft-is-safe-in-hiv-positive-patients-but-shows-higher-risk-of-longer-term-events","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/7704","title":{"rendered":"Coronary artery bypass graft is safe in HIV-positive patients but shows higher risk of longer term events"},"content":{"rendered":"<p><strong>Graham McKerrow, HIV i-Base<\/strong><\/p>\n<p><strong>Coronary artery bypass graft (CABG) is a feasible and safe procedure in HIV-positive patients, conclude Boccara and colleagues at the French Italian Study on Coronary artery disease in AIDS patients (FRISCA-2). There was no difference in immediate postoperative outcomes between HIV-positive and HIV-negative patients. However. long-term follow-up showed higher rates of major adverse cardiac events (MACE) was significantly higher in HIV-positive patients due to an increased rate of repeat revascularisation procedure (reCABG and percutaneous coronary intervention [PCI]).<\/strong><\/p>\n<p>From 1997 to 2003 inclusive, researchers compared 22 HIV-positive and 42 HIV-negative control patients matched for age and gender who underwent CABG. They compared baseline characteristics, immediate results and clinical outcome (MACE: death from any cause, myocardial infarction, re-intervention and\/or PCI) at 34 months.<\/p>\n<p>Cardiovascular risk factors were nearly identical in both groups with a higher rate of hypercholesterolaemia (96% versus 74%, p=0.045) and hypertriglyceridaemia (82% versus 45%, p=0.005) in HIV-positive patients. Obesity was more frequent in the control group (33% versus 0%, p=0.001).<\/p>\n<p>In the HIV-positive group, mean CD4 count was lower post-operation compared to beforehand (427 +\/- 162 vs 503 +\/-200 cells\/mm<sup>3<\/sup>) but this was without clinical significance in the follow-up. Coronary multivessel disease (&gt; 2 vessel disease) was present in nearly all patients (96% HIV-positive and 93% HIV-negative). Left Ventricular Ejection Fraction and mean number of grafts were also similar in the 2 groups (55%+\/-10 versus 50%+\/-14, respectively.<\/p>\n<p>After one month, the rate of post-operative death, MI, stroke, mediastinitis, and re-intervention was identical in both groups. However, at 34 +\/-20 months follow-up, rate of occurrence of first MACE was higher in HIV-positive group. The only predictor of MACE at follow-up was HIV infection itself with a hazard ratio of 6.3 (95%CI 2.2-17.9, p=0.001).<\/p>\n<p>Reference:<\/p>\n<p>Boccara F, Cohen A, Odi G et al. Coronary artery bypass graft in HIV-infected patients. A multicentre case control study. 6th Lipodystrophy Workshop (6th IWADRLH), Washington. <a href=\"http:\/\/www.aegis.org\/conferences\/lipo\/2004\/115.html\">Abstract 115<\/a>. Antiviral Therapy 2004; 9:L65.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Graham McKerrow, HIV i-Base Coronary artery bypass graft (CABG) is a feasible and safe procedure in HIV-positive patients, conclude Boccara and colleagues at the French Italian Study on Coronary artery disease in AIDS patients (FRISCA-2). There was no difference in &hellip;<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,6],"tags":[127],"class_list":["post-7704","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-other-news","tag-lipo-6th-2004"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/7704","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=7704"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/7704\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=7704"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=7704"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=7704"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}