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Author Topic: Acute Coronary Syndrome in the setting of HIV  (Read 2225 times)

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Offline shawnodese

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Acute Coronary Syndrome in the setting of HIV
« on: October 21, 2017, 01:02:09 pm »
For those who are hiv positive and have had a heart attack and received a drug eluding stent, or know someone who has, what is the current HIV standard of care regarding continuing dual antiplatelet therapy (DAPT) with an ADP receptor antagonist such as Clopidogrel or Prasugrel plus aspirin beyond the mandatory one year period?  Many traditional cardiologists tend to stop the Clopidogrel or Prasugrel and have the patient continue with aspirin alone after one year, but is this wise to do in the setting of HIV where there is a chronic underlying state of inflammation in the blood vessels and possibly a few remaining unstable plaques that can rupture if statin therapy is not keeping them dampened down?  And then there is also the association of certain antiviral drugs with acute coronary syndrome although most hiv providers get their middle age and older patients off of abacavir or protease inhibitors after an event has occurred.  So in the setting of hiv would the benefits of continuing DAPT, possibly indefinitely, outweigh the risks of bleeding or other complications?  What do you or your hiv doc / cardiologist think about this?   
« Last Edit: October 21, 2017, 01:32:31 pm by shawnodese »

 


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