HIV disease in thrombocardiology.

Human immunodeficiency virus (HIV) infection affects multiple organs including the cardiovascular system. Postmortem studies have revealed multiple abnormalities including abnormal coronary artery pathology, arteriopathy/endothelial dysfunction, hyperlipidemia and hypercoagulability prior to the use of protease inhibitors. With the introduction of antiretroviral medications, specifically protease inhibitor therapy, patients with HIV have been further noted to have premature coronary artery disease, hypercoagulability, hyperlipidemia, insulin resistance, fat redistribution syndrome and increased tendency to myocardial infarction. In this article, we report on one patient with HIV disease on protease inhibitor therapy that presented with non-Q-wave myocardial infarction and underwent percutaneous coronary intervention, and was later found to have stent thrombosis. A review of the literature showed no other previous reports of stent thrombosis secondary to acquired hypercoagulability due to protease inhibitor therapy. Possible predictors of stent thrombosis and hypercoagulability are also discussed.