Outcomes of coronary artery bypass grafting in patients with human immunodeficiency virus infection

• Published in: Journal of cardiac surgery Vol. 35; no. 10; pp. 2543 - 2549
• Main Authors: Wollner, Gregor, Zimpfer, Daniel, Manduric, Marina, Laufer, Günther, Rieger, Armin, Sandner, Sigrid E.
• Format: Journal Article
• Language: English
• Published: United States John Wiley and Sons Inc 01.10.2020
• Subjects: Aged; Cardiovascular Diseases - epidemiology; Coronary Artery Bypass - adverse effects; coronary artery bypass grafting; coronary artery disease; Coronary Artery Disease - complications; Coronary Artery Disease - mortality; Coronary Artery Disease - surgery; Female; highly active antiretroviral therapy; HIV Infections - complications; human immunodeficiency virus infection; Humans; Male; Middle Aged; Myocardial Infarction - epidemiology; Original; Postoperative Complications - epidemiology; Retrospective Studies; Stroke - epidemiology; Survival Rate; Treatment Outcome; coronary artery disease; highly active antiretroviral therapy; human immunodeficiency virus infection; coronary artery bypass grafting
• ISSN: 0886-0440; 1540-8191
• DOI: 10.1111/jocs.14828

Background With early and effective antiretroviral therapy and improved survival for persons living with human immunodeficiency virus infection (PLHIV), this patient population now faces an increasingly elevated risk of cardiovascular disease. However, the data on outcomes after coronary artery bypass grafting (CABG) for revascularization of coronary artery disease (CAD) in HIV+ patients is limited. Methods We conducted a retrospective analysis of 16 patients undergoing isolated CABG at the Medical University of Vienna from 2005 to 2018, who were HIV+ on admission. The primary endpoint of the study was survival. Secondary endpoints included the components of major adverse cardiac and cerebrovascular events (MACCE): cardiovascular death, stroke, myocardial infarction (MI), and repeat revascularization. Results Patients were followed for a median of 49 months (range, 7‐142 months). Survival was 100% and 90% at 1 and 3 years after CABG, respectively. There were no strokes. MI and subsequent repeat revascularization were observed in two patients. Conclusion CABG provides excellent short‐ and midterm survival and freedom from MACCE in HIV+ patients with CAD requiring revascularization.