Infection with human immunodeficiency virus (HIV) is no longer an automatic death sentence, thanks to the use of highly active anti-retroviral therapy (HAART).
However, several studies questions have suggested that HIV infection poses a serious threat to the heart -- specifically, that HIV positivity leads to an increased risk for the development of angiographically severe coronary artery disease (CAD). But Emory research presented by Amar D. Patel, MD, today at the American College of Cardiology (ACC) 54th Annual Scientific Sessions in Orlando today reaches a different conclusion.
Emory researchers studied all patients who underwent cardiac catheterization (due to acute coronary syndrome or an abnormal cardiac stress test) at Grady Memorial Hospital in Atlanta between January 2001 and December 2001. The patients were evaluated for HIV infection, common cardiac risk factors, HAART, and findings on coronary angiography.
"We then used multivariate analyses to determine the relationship between HIV status and angiographically severe CAD in 525 patients," explains Emory Heart Center cardiologist and research team member Srikanth Sola, MD. "We found that 5 percent were HIV positive and 21 percent were admitted with a heart attack. But only 1.4 percent of the heart attack group was HIV positive."
Cardiac catheterization revealed that 213 patients (45%) had severe CAD stenosis and 14 patients of these patients were HIV positive. "At first, it appeared that HIV status was significantly associated with angiographically severe heart disease. However, after we adjusted for age, gender, hypertension, diabetes, high cholesterol levels and tobacco use, HIV status was no longer associated with severe CAD," says Dr. Sola. "In fact, there was no significant relationship between angiographically significant CAD and HAART, CD4 count, or HIV viral load."