array:25 [
  "pii" => "S2174204917301629"
  "issn" => "21742049"
  "doi" => "10.1016/j.repce.2016.10.019"
  "estado" => "S300"
  "fechaPublicacion" => "2017-07-01"
  "aid" => "996"
  "copyright" => "Sociedade Portuguesa de Cardiologia"
  "copyrightAnyo" => "2017"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "crp"
  "cita" => "Rev Port Cardiol. 2017;36:569.e1-8"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 3190
    "formatos" => array:3 [
      "EPUB" => 147
      "HTML" => 2569
      "PDF" => 474
    ]
  ]
  "Traduccion" => array:1 [
    "pt" => array:20 [
      "pii" => "S087025511730286X"
      "issn" => "08702551"
      "doi" => "10.1016/j.repc.2016.10.009"
      "estado" => "S300"
      "fechaPublicacion" => "2017-07-01"
      "aid" => "996"
      "copyright" => "Sociedade Portuguesa de Cardiologia"
      "documento" => "simple-article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "crp"
      "cita" => "Rev Port Cardiol. 2017;36:569.e1-8"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 4376
        "formatos" => array:3 [
          "EPUB" => 209
          "HTML" => 3694
          "PDF" => 473
        ]
      ]
      "pt" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Caso cl&#237;nico</span>"
        "titulo" => "VIH e doen&#231;a coron&#225;ria &#8211; quando a preven&#231;&#227;o secund&#225;ria &#233; insuficiente"
        "tienePdf" => "pt"
        "tieneTextoCompleto" => "pt"
        "tieneResumen" => array:2 [
          0 => "pt"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "569&#46;e1"
            "paginaFinal" => "569&#46;e8"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "HIV and coronary disease &#8211; When secondary prevention is insufficient"
          ]
        ]
        "contieneResumen" => array:2 [
          "pt" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "pt" => true
        ]
        "contienePdf" => array:1 [
          "pt" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0010"
            "etiqueta" => "Figura 2"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr2.jpeg"
                "Alto" => 609
                "Ancho" => 1800
                "Tamanyo" => 111660
              ]
            ]
            "descripcion" => array:1 [
              "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">a&#41; Trombose de <span class="elsevierStyleItalic">stent</span> na CD &#40;seta&#41;&#59; b&#41; imagem de subtra&#231;&#227;o intraluminal sugestiva de dissec&#231;&#227;o da CD &#40;seta&#41;&#59; c&#41; CD p&#243;s aspira&#231;&#227;o de trombos&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Ana Sofia Carvalho, Rui Os&#243;rio Valente, Lu&#237;s Almeida Morais, Pedro Modas Daniel, Ramiro S&#225; Carvalho, Lurdes Ferreira, Rui Cruz Ferreira"
            "autores" => array:7 [
              0 => array:2 [
                "nombre" => "Ana Sofia"
                "apellidos" => "Carvalho"
              ]
              1 => array:2 [
                "nombre" => "Rui"
                "apellidos" => "Os&#243;rio Valente"
              ]
              2 => array:2 [
                "nombre" => "Lu&#237;s"
                "apellidos" => "Almeida Morais"
              ]
              3 => array:2 [
                "nombre" => "Pedro"
                "apellidos" => "Modas Daniel"
              ]
              4 => array:2 [
                "nombre" => "Ramiro"
                "apellidos" => "S&#225; Carvalho"
              ]
              5 => array:2 [
                "nombre" => "Lurdes"
                "apellidos" => "Ferreira"
              ]
              6 => array:2 [
                "nombre" => "Rui"
                "apellidos" => "Cruz Ferreira"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "pt"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2174204917301629"
          "doi" => "10.1016/j.repce.2016.10.019"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917301629?idApp=UINPBA00004E"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087025511730286X?idApp=UINPBA00004E"
      "url" => "/08702551/0000003600000078/v1_201707241250/S087025511730286X/v1_201707241250/pt/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S2174204917301617"
    "issn" => "21742049"
    "doi" => "10.1016/j.repce.2017.06.001"
    "estado" => "S300"
    "fechaPublicacion" => "2017-07-01"
    "aid" => "965"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "crp"
    "cita" => "Rev Port Cardiol. 2017;36:571&#46;e1-4"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2983
      "formatos" => array:3 [
        "EPUB" => 198
        "HTML" => 2319
        "PDF" => 466
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>"
      "titulo" => "Late incidental diagnosis of intrapericardial teratoma &#8211; A case report"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "571&#46;e1"
          "paginaFinal" => "571&#46;e4"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Diagn&#243;stico incidental tardio de teratoma intraperic&#225;rdico &#8211; relato de caso"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 657
              "Ancho" => 1600
              "Tamanyo" => 83197
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Cardiac magnetic resonance imaging with double inversion recovery &#40;A&#41; and double inversion recovery with fat saturation &#40;B&#41;&#44; showing areas of hyperintensity and hyposignal suggesting possible liquid&#44; fat or bloody&#47;high-protein components inside the compartments of the complex pericardial cyst&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Annelisa Moura Garcia, Roberto Nery Dantas Junior, Chang K&#46; Chi, Jos&#233; Rodrigues Parga"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Annelisa"
              "apellidos" => "Moura Garcia"
            ]
            1 => array:2 [
              "nombre" => "Roberto"
              "apellidos" => "Nery Dantas Junior"
            ]
            2 => array:2 [
              "nombre" => "Chang K&#46;"
              "apellidos" => "Chi"
            ]
            3 => array:2 [
              "nombre" => "Jos&#233;"
              "apellidos" => "Rodrigues Parga"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "pt" => array:9 [
        "pii" => "S0870255117301282"
        "doi" => "10.1016/j.repc.2016.09.015"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "pt"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117301282?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917301617?idApp=UINPBA00004E"
    "url" => "/21742049/0000003600000078/v1_201707290050/S2174204917301617/v1_201707290050/en/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S2174204917302088"
    "issn" => "21742049"
    "doi" => "10.1016/j.repce.2017.05.008"
    "estado" => "S300"
    "fechaPublicacion" => "2017-07-01"
    "aid" => "1025"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "rev"
    "cita" => "Rev Port Cardiol. 2017;36:551-67"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 8347
      "formatos" => array:3 [
        "EPUB" => 240
        "HTML" => 7460
        "PDF" => 647
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Review Article</span>"
      "titulo" => "Aspirin and blood pressure&#58; Effects when used alone or in combination with antihypertensive drugs"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "551"
          "paginaFinal" => "567"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Aspirina e press&#227;o arterial&#58; efeitos do uso isolado ou em associa&#231;&#227;o com f&#225;rmacos anti-hipertensores"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0015"
          "etiqueta" => "Figure 3"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr3.jpeg"
              "Alto" => 2415
              "Ancho" => 3000
              "Tamanyo" => 447467
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Major protective effects of low-dose aspirin&#46; AA&#58; arachidonic acid&#59; ATL&#58; aspirin-triggered lipoxin&#59; COX-1&#58; cyclooxygenase-1&#59; COX-2&#58; cyclooxygenase-2&#59; eNOS&#58; endothelial nitric oxide synthase&#59; NO&#58; nitric oxide&#59; PD&#58; protectin&#59; Rvs&#58; resolvins&#59; TXA<span class="elsevierStyleInf">2</span>&#58; thromboxane A<span class="elsevierStyleInf">2</span>&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ana Catarina Costa, Marta Reina-Couto, Ant&#243;nio Albino-Teixeira, Teresa Sousa"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Ana Catarina"
              "apellidos" => "Costa"
            ]
            1 => array:2 [
              "nombre" => "Marta"
              "apellidos" => "Reina-Couto"
            ]
            2 => array:2 [
              "nombre" => "Ant&#243;nio"
              "apellidos" => "Albino-Teixeira"
            ]
            3 => array:2 [
              "nombre" => "Teresa"
              "apellidos" => "Sousa"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0870255117302895"
        "doi" => "10.1016/j.repc.2017.05.008"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117302895?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917302088?idApp=UINPBA00004E"
    "url" => "/21742049/0000003600000078/v1_201707290050/S2174204917302088/v1_201707290050/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>"
    "titulo" => "HIV and coronary disease &#8211; When secondary prevention is insufficient"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "569&#46;e1"
        "paginaFinal" => "569&#46;e8"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Ana Sofia Carvalho, Rui Os&#243;rio Valente, Lu&#237;s Almeida Morais, Pedro Modas Daniel, Ramiro S&#225; Carvalho, Lurdes Ferreira, Rui Cruz Ferreira"
        "autores" => array:7 [
          0 => array:4 [
            "nombre" => "Ana Sofia"
            "apellidos" => "Carvalho"
            "email" => array:1 [
              0 => "asofia&#46;dc&#64;gmail&#46;com"
            ]
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "fn0005"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Rui"
            "apellidos" => "Os&#243;rio Valente"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "fn0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Lu&#237;s"
            "apellidos" => "Almeida Morais"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Pedro"
            "apellidos" => "Modas Daniel"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Ramiro"
            "apellidos" => "S&#225; Carvalho"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Lurdes"
            "apellidos" => "Ferreira"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Rui"
            "apellidos" => "Cruz Ferreira"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Servi&#231;o de Medicina Interna&#44; Hospital Egas Moniz Centro Hospitalar de Lisboa Ocidental&#44; Lisboa&#44; Portugal"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servi&#231;o de Medicina Interna&#44; Hospital Beatriz &#194;ngelo&#44; Loures&#44; Portugal"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Servi&#231;o de Cardiologia&#44; Hospital de Santa Marta&#44; Centro Hospitalar Lisboa Central&#44; Lisboa&#44; Portugal"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "VIH e doen&#231;a coron&#225;ria &#8211; quando a preven&#231;&#227;o secund&#225;ria &#233; insuficiente"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1153
            "Ancho" => 1800
            "Tamanyo" => 381786
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; Right coronary artery &#40;RCA&#41; dissection visible by optical coherence tomography &#40;OCT&#41;&#59; &#40;b&#41; and &#40;c&#41; intrastent thrombosis in RCA visible by OCT&#59; &#40;d-f&#41; intrastent view of the RCA by OCT after thrombus aspiration&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The advent of highly active antiretroviral therapy &#40;HAART&#41; has led to a marked decrease in morbidity and mortality among patients with human immunodeficiency virus &#40;HIV&#41; infection&#44;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">1&#8211;4</span></a> and a consequent increase in their life expectancy and in the prevalence of chronic diseases not previously associated with HIV&#46; These include cardiovascular and liver disease and cancer&#44;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">5&#8211;7</span></a> the treatment of which is becoming increasingly important in these patients&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">There is in fact a well-documented higher risk of coronary artery disease &#40;CAD&#41; in HIV patients compared to the general population&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">3&#44;8&#44;9</span></a> In a study carried out by the Antiretroviral Therapy Cohort Collaboration&#44;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">6</span></a> which included 39<span class="elsevierStyleHsp" style=""></span>272 patients from 13 cohorts of patients receiving HAART between 1996 and 2006 in Europe and the USA&#44; mortality attributed to cardiovascular disease in HIV patients was 7&#46;9&#37; &#40;40&#37; of which was due to CAD or myocardial infarction &#91;MI&#93; and 18&#37; to stroke&#41;&#46; The D&#58;A&#58;D study&#44;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">7</span></a> which was completed later and included 49<span class="elsevierStyleHsp" style=""></span>731 patients followed between 1999 and 2011 in clinics in Europe&#44; the USA and Australia&#44; reported mortality of 11&#37; due to cardiovascular disease&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">There are few data on the risk of adverse cardiovascular events in HIV-infected patients undergoing percutaneous coronary intervention &#40;PCI&#41; with drug-eluting stents in the context of acute coronary syndrome &#40;ACS&#41;&#46; Some studies<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">10&#8211;12</span></a> have reported similar rates for infected and non-infected patients&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">We report the case of an HIV patient with diabetes who presented acute thrombosis of drug-eluting stents in two different coronary arteries four hours after hospital discharge&#44; which manifested as ST-elevation MI&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">An unusual case of acute stent thrombosis in an HIV patient is presented&#44; together with a literature review and discussion of possible explanations for this atypical presentation&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Case report</span><p id="par0030" class="elsevierStylePara elsevierViewall">A 57-year-old man&#44; black&#44; born in Guinea and resident in Portugal since 1982&#44; an astrologer&#44; had a personal history of co-infection with HIV-2 and hepatitis B virus &#40;HBV&#41;&#46; HIV-2 was diagnosed in 1997 &#40;19 years before this hospitalization&#41;&#44; when HAART was begun&#46; The patient&#39;s CD4&#43; T cell count before therapy is unknown&#46; He was regularly monitored and complied with therapy&#44; which included the antiretrovirals lamivudine&#44; stavudine&#44; indinavir and abacavir&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The patient&#39;s viral load and CD4&#43; T cell count were generally under control from the time of diagnosis&#44; except for a period of one year approximately two years before this admission&#44; when he presented an increased viral load &#40;maximum 4500 copies&#47;ml&#44; although his CD4&#43; T cell count was controlled throughout this period&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">At admission&#44; the patient was under combined HAART&#44; namely tenofovir and emtricitabine 300 mg&#47;200 mg once daily&#59; darunavir in combination with ritonavir 600 mg&#47;100 mg twice daily and raltegravir 400 mg twice daily&#46; He presented adequate CD4&#43; T cell counts and negative viral load&#46; HBV infection was diagnosed in 2010 &#40;six years before this hospitalization&#41;&#44; and regular monitoring continued to show negative viral load under tenofovir therapy&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">He had a history of insulin-treated type 2 diabetes&#44; diagnosed 17 years prior to this admission&#44; with no known microvascular complications&#44; and mixed dyslipidemia &#40;predominantly hypertriglyceridemia&#41;&#44; diagnosed 10 years previously&#46; Laboratory tests at the time of diagnosis showed total cholesterol 205 mg&#47;dl&#44; high density lipoprotein &#40;HDL&#41; cholesterol 21 mg&#47;dl&#44; low density lipoprotein &#40;LDL&#41; cholesterol 90 mg&#47;dl&#44; and triglycerides 265 mg&#47;dl&#46; Therapy with fenofibrate 145 mg&#47;daily was begun&#44; which the patient had continued ever since&#46; Persistently high total and LDL cholesterol levels during follow-up led to atorvastatin 20 mg being added around four years previously&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The patient had no other risk factors&#44; including smoking&#44; cocaine use&#44; hypertension&#44; obesity or family history of sudden death&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Besides HAART&#44; he was thus being medicated as an outpatient with atorvastatin 20 mg&#44; fenofibrate 145 mg&#44; pantoprazole 20 mg&#44; linagliptin 5 mg and insulin &#40;Insulatard<span class="elsevierStyleSup">&#174;</span>&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The patient went to the emergency department &#40;ED&#41; due to right chest pain radiating to the neck that had begun that morning as soon as he arose&#44; not associated with effort and with no aggravating or alleviating factors&#46; He reported no respiratory or gastrointestinal problems&#44; fever or history of trauma&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Physical examination on admission to the ED revealed no significant alterations&#46; Diagnostic exams included an ECG&#44; which showed sinus rhythm and right bundle branch block &#40;RBBB&#41;&#44; but no ST-segment changes&#46; Laboratory tests revealed hemoglobin 11&#46;5 g&#47;dl&#44; sodium 134 mmol&#47;l&#44; potassium 4&#46;6 mmol&#47;l&#44; chloride 100 mmol&#47;l&#44; urea 56 mg&#47;dl&#44; creatinine 1&#46;46 mg&#47;dl &#40;estimated glomerular filtration rate 61 ml&#47;min&#47;1&#46;73 m<span class="elsevierStyleSup">2</span> according to the Chronic Kidney Disease Epidemiology Collaboration equation&#41;&#44; and increased myocardial necrosis markers &#40;high-sensitivity troponin I 348&#46;5 &#956;g&#47;l at first assessment and 392&#46;2 &#956;g&#47;l at second assessment&#44; a rise of 13&#37;&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">A diagnosis of non-ST elevation MI was made&#44; a loading dose of dual antiplatelet therapy &#40;aspirin and clopidogrel&#41; was administered and the patient was admitted&#46; He presented no further episodes of chest pain&#44; myocardial necrosis markers fell from 409&#46;9 &#956;g&#47;l &#40;peak&#41; to 78&#46;2 &#956;g&#47;l and there were no new ECG alterations&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Coronary angiography on the fourth day of hospital stay showed two-vessel disease &#40;90&#37; stenosis of the mid segment of the right coronary artery &#91;RCA&#93;&#44; and 95&#37; stenosis of the first marginal&#41;&#44; and two drug-eluting stents were successfully implanted&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">The patient remained hemodynamically stable under dual antiplatelet therapy &#40;aspirin 100 mg&#47;daily and clopidogrel 75 mg&#47;daily&#41; and high-dose statin therapy &#40;atorvastatin 40 mg&#41;&#46; Bisoprolol and lisinopril were also started during hospital stay&#46; The patient also received the same antiretroviral therapy he had been receiving as an outpatient&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Laboratory tests during hospitalization showed poor metabolic control&#44; with glycosylated hemoglobin 9&#46;2&#37; &#40;7&#46;0&#37; three months previously&#41; and undetectable HBV and HIV-2 viral loads&#46; The patient&#39;s lipid profile at admission was total cholesterol 142 mg&#47;dl&#44; HDL cholesterol 18 mg&#47;dl&#44; LDL cholesterol 52 mg&#47;dl &#40;by direct measurement&#41;&#44; and triglycerides 326 mg&#47;dl&#46; Testing for thrombophilia included measurement of protein S&#44; protein C&#44; homocysteine&#44; factor V Leiden&#44; antithrombin and von Willebrand factor&#44; all of which were within the reference range&#59; screening for anti-nuclear antibodies and lupus anticoagulant was also negative&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">The patient was discharged on the 11th day of hospitalization&#44; under the medication described above and maintaining the antiretroviral therapy he was receiving at admission&#46; There were no further complications&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">He returned to the ED four hours after discharge&#44; due to chest pain radiating to his left arm&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">The ECG showed sinus rhythm&#44; RBBB and ST elevation in leads DII&#44; DIII&#44; and aVF and ST depression in leads V1-V3 &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">Coronary angiography was performed within an hour of pain onset&#44; and revealed occlusion of both stents &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>a and b&#41;&#46; Optical coherence tomography &#40;OCT&#41; of the two arteries was performed to clarify the situation&#46; OCT of the RCA showed good stent apposition&#44; intrastent thrombus and dissection beginning at the distal margin of the stent &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>a-c&#41;&#44; while OCT of the first marginal showed good apposition and intrastent thrombi but no dissection &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Figure 4</a>a&#44; c-e&#41;&#46; Angioplasty of the mid segment of the RCA was then performed&#44; and a stent was implanted after thrombus aspiration &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>d-f&#41;&#44; as well as balloon angioplasty of the first marginal after thrombus aspiration &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Figure 4</a>b&#41;&#46; There was a good final result&#44; TIMI 3 flow being re-established in both arteries&#46; A glycoprotein IIb&#47;IIIa inhibitor &#40;abciximab&#41; was administered&#44; due to the patient&#39;s high thrombotic burden&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">After the procedure it was decided to replace clopidogrel by ticagrelor&#46; The patient experienced no recurrence of pain or new ECG alterations during the rest of hospital stay&#46; He was discharged medicated with aspirin 100 mg once daily&#44; ticagrelor 90 mg twice daily&#44; bisoprolol 5 mg once daily and lisinopril 20 mg once daily&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">At the time this case report was prepared&#44; the patient had undergone cardiological assessment after four months of follow-up&#44; and no further ischemic complications were recorded&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0120" class="elsevierStylePara elsevierViewall">The increased life expectancy of HIV-infected patients following the introduction of HAART has been accompanied by an increased prevalence of metabolic disorders&#44; which raises new problems for their management&#46;</p><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">HIV and the pathophysiology of cardiovascular disease</span><p id="par0125" class="elsevierStylePara elsevierViewall">Various factors are known to increase the risk of cardiovascular disease in HIV patients&#46; On one hand&#44; this population has a high prevalence of conventional risk factors&#44;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">13</span></a> particularly smoking&#44;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">13&#44;14</span></a> low HDL cholesterol&#44; hypertriglyceridemia and hypertension&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">13</span></a> Some studies<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">15</span></a> report that the incidence of diabetes in HIV patients exposed to HAART is four times higher that in seronegative patients&#46; On the other hand&#44; complex pathophysiological mechanisms related to the virus itself also play a part&#44; resulting from persistent immunodeficiency&#44; immune dysregulation&#44; immune activation and inflammation&#44;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">16</span></a> even in patients under HAART&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Endothelial dysfunction&#44; a key element of atherogenesis&#44; is the end result of various processes that coexist in the presence of HIV&#44; including direct and indirect endothelial injury &#40;via immune reactions or drugs&#41;&#44; destruction of CD4&#43; T cells &#40;accompanied by an increase in shed membrane particles that induce endothelial dysfunction&#41; and enhanced expression of adhesion molecules &#40;via increased cytokine activity or as a direct effect of the virus&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">17&#44;18</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">There is thus a persistent inflammatory state in these patients that results in vascular damage and premature atherosclerosis&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">19</span></a> Some studies have shown a significant increase in non-calcified plaques in HIV patients treated with HAART&#44; which may also be associated with cardiovascular events&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">20</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">An increased risk of CAD has also been demonstrated in HIV patients compared to the general population&#44; occurring at an earlier age<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">3</span></a> and with more aggressive characteristics &#40;greater prevalence of ST-elevation MI and multivessel involvement&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">2</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">In addition&#44; HAART also causes metabolic changes that further increase risk in these patients&#44; including metabolic syndrome&#44; characterized by dyslipidemia &#40;predominantly hypertriglyceridemia&#41; and insulin resistance&#44; frequently associated with abnormal fat distribution and lipodystrophy&#46;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">21&#44;22</span></a> This&#44; while HAART helps to reduce endothelial injury by controlling HIV infection&#44; it also activates the endothelium by interfering in glucose and lipid metabolism&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">23</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">Assessing the relationship between HAART and cardiovascular risk is complicated&#44; since the currently recommended combined therapy regimes include drugs of various classes&#44; making it difficult to draw reliable conclusions&#46; In addition&#44; many patients are medicated with different regimes over time&#44; due to therapeutic failure or adverse effects&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Data from the D&#58;A&#58;D study&#44;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">24</span></a> which analyzed the association between HAART and risk of MI&#44; showed that of the protease inhibitors&#44; only indinavir and lopinavir-ritonavir were associated with a significantly increased risk of MI&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">In the same cohort&#44; of nucleoside reverse transcriptase inhibitors&#44; only abacavir and didanosine were significantly associated with risk of MI&#46; There have been many studies on abacavir in particular&#44; but with conflicting results&#46; Some report an association between current or recent exposure to abacavir and increased risk of MI&#44;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">25</span></a> while others found no evidence of such an association&#46;<a class="elsevierStyleCrossRefs" href="#bib0300"><span class="elsevierStyleSup">26&#44;27</span></a> There is in fact no known biological mechanism to explain the association&#44; although experimental studies have suggested various potential explanations&#44; including endothelial dysfunction and the ability of abacavir to induce inflammation of the vascular wall by enhancing leukocyte attachment to endothelial cells&#44; and possibly to increase platelet activation&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">28</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Incidence of acute-phase reinfarction or restenosis in HIV patients</span><p id="par0165" class="elsevierStylePara elsevierViewall">The prognosis of HIV patients in the acute phase of ACS has been analyzed in only a small number of works&#46; A nationwide study in the USA between 1997 and 2006<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">29</span></a> found a higher rate of in-hospital mortality in HIV patients admitted with ACS &#40;with or without ST elevation&#41;&#44; although there were differences in the treatment offered in the seropositive and seronegative groups&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Some authors argue that HIV patients undergoing PCI present higher incidences of reinfarction&#44; restenosis and stent thrombosis as a result of their prothrombotic state&#44;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">2&#44;30&#44;31</span></a> although few other studies have demonstrated such an association&#46; Hsue et al&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">32</span></a> reported a higher restenosis rate after PCI in HIV-infected patients than in controls &#40;52&#37; vs&#46; 14&#37;&#44; p&#61;0&#46;006&#41;&#44; but other studies<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">10&#44;11</span></a> have reported similar rates of cardiovascular adverse events in patients with and without HIV infection undergoing PCI with drug-eluting stents in the context of ACS&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Given the higher prothrombotic risk of these patients&#44;<a class="elsevierStyleCrossRefs" href="#bib0335"><span class="elsevierStyleSup">33&#44;34</span></a> it is important to investigate whether there is in fact a relationship between HIV infection and risk of stent thrombosis&#46; In addition&#44; there have been no studies assessing the impact of a more aggressive approach to treating conventional risk factors in HIV patients with a view to reducing their cardiovascular risk&#46; Further studies are needed to increase our knowledge in areas such as reducing immune activation&#44; chronic inflammation and residual viremia&#44; and the possible relationship between antiretroviral therapy and stent thrombosis&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Particular aspects of the case reported</span><p id="par0180" class="elsevierStylePara elsevierViewall">In the case presented&#44; even though the patient had other cardiovascular risk factors&#44; HIV infection appears to be the main factor involved in stent thrombosis so soon after hospital discharge in an individual with optimized secondary prevention therapy&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">One possible explanation for stent thrombosis in the RCA would be dissection of the artery that had not been visualized on initial coronary angiography and that contributed to the thrombotic event&#44; since OCT revealed good apposition&#44; intrastent thrombus and dissection beginning at the distal margin of the stent&#46; Nevertheless&#44; this is highly unlikely&#44; since it does not explain thrombosis of two stents in different arteries&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">The factor that could explain acute thrombosis of both stents is therefore increased thrombotic risk conferred by HIV infection and by diabetes&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">There are no specific guidelines with regard to antiplatelet therapy in HIV-infected patients and the decision to replace clopidogrel by ticagrelor in this case was based not on evidence but on the failure of previous therapy&#46; It would be interesting to know whether the new P2Y12 inhibitors are more effective at secondary prevention of cardiovascular events in HIV patients&#44; and should therefore be used as first-line therapy&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusions</span><p id="par0200" class="elsevierStylePara elsevierViewall">The transformation of HIV infection from a disease with high short-term mortality to a chronic disease has raised new and pressing research questions regarding the cardiovascular risk of this population&#44; given their known risk profile&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">The current approach to reducing cardiovascular risk consists of early initiation of HAART and adequate control of conventional risk factors&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">However&#44; the case presented highlights the fact that adequate control of HIV infection and conventional risk factors may be insufficient&#44; and raises various questions that require thorough investigation&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">Finally&#44; a multidisciplinary approach will help in choosing the most appropriate care for these patients&#44; with emphasis on the role of the cardiologist&#44; infectologist and internist&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Ethical disclosures</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Protection of human and animal subjects</span><p id="par0220" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Confidentiality of data</span><p id="par0225" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Right to privacy and informed consent</span><p id="par0230" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conflicts of interest</span><p id="par0235" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres875797"
          "titulo" => "Abstract"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0005"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec863893"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres875798"
          "titulo" => "Resumo"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0010"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec863894"
          "titulo" => "Palavras-chave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Case report"
        ]
        6 => array:3 [
          "identificador" => "sec0015"
          "titulo" => "Discussion"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "HIV and the pathophysiology of cardiovascular disease"
            ]
            1 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Incidence of acute-phase reinfarction or restenosis in HIV patients"
            ]
            2 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Particular aspects of the case reported"
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Conclusions"
        ]
        8 => array:3 [
          "identificador" => "sec0040"
          "titulo" => "Ethical disclosures"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Protection of human and animal subjects"
            ]
            1 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Confidentiality of data"
            ]
            2 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Right to privacy and informed consent"
            ]
          ]
        ]
        9 => array:2 [
          "identificador" => "sec0060"
          "titulo" => "Conflicts of interest"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2016-04-06"
    "fechaAceptado" => "2016-10-03"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec863893"
          "palabras" => array:3 [
            0 => "Human immunodeficiency virus"
            1 => "Stent thrombosis"
            2 => "Coronary disease"
          ]
        ]
      ]
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras-chave"
          "identificador" => "xpalclavsec863894"
          "palabras" => array:3 [
            0 => "V&#237;rus da imunodefici&#234;ncia humana"
            1 => "Trombose de <span class="elsevierStyleItalic">stent</span>"
            2 => "Doen&#231;a coron&#225;ria"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Highly active antiretroviral therapy &#40;HAART&#41; has created a new paradigm for human immunodeficiency virus &#40;HIV&#41;-infected patients&#44; but their increased risk for coronary disease is well documented&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We present the case of a 57-year-old man&#44; co-infected with HIV-2 and hepatitis B virus&#44; adequately controlled and with insulin-treated type 2 diabetes and dyslipidemia&#44; who was admitted with non-ST elevation acute myocardial infarction&#46; Coronary angiography performed on day four of hospital stay documented two-vessel disease &#40;mid segment of the right coronary artery &#91;RCA&#44; 90&#37; stenosis&#93; and the first marginal&#41;&#46; Two drug-eluting stents were successfully implanted&#46; The patient was discharged under dual antiplatelet therapy &#40;aspirin 100 mg&#47;day and clopidogrel 75 mg&#47;day&#41; and standard coronary artery disease medication&#46; He was admitted to the emergency room four hours after discharge with chest pain radiating to the left arm and inferior ST-segment elevation myocardial infarction was diagnosed&#46; Coronary angiography was performed within one hour and documented thrombosis of both stents&#46; Optical coherence tomography revealed good apposition of the stent in the RCA&#44; with intrastent thrombus&#46; Angioplasty was performed&#44; with a good outcome&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The acute stent thrombosis might be explained by the thrombotic potential of HIV infection and diabetes&#46; There are no specific guidelines regarding HAART in secondary prevention of acute coronary syndromes&#46; A multidisciplinary approach is essential for optimal management of these patients&#46;</p></span>"
      ]
      "pt" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A terap&#234;utica antiretroviral &#40;TARV&#41; alterou o paradigma da infe&#231;&#227;o pelo v&#237;rus da imunodefici&#234;ncia humana &#40;VIH&#41;&#44; conhecendo-se o risco aumentado de doen&#231;a coron&#225;ria nestes doentes&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Apresenta-se o caso de um homem de 57 anos&#44; melanod&#233;rmico&#44; com coinfec&#231;&#227;o VIH-2&#47;v&#237;rus hepatite B&#44; com controlo adequado&#59; diabetes <span class="elsevierStyleItalic">mellitus</span> tipo 2&#44; insulino-tratado e dislipidemia&#46; Internado por enfarte agudo do mioc&#225;rdio&#44; sem supradesnivelamento ST&#46; Realizou cateterismo ao 4&#46;&#176; dia de internamento&#44; documentando-se doen&#231;a de dois vasos &#40;segmento m&#233;dio da coron&#225;ria direita &#91;CD&#93; &#91;90&#37; estenose&#93; e 1&#46;&#170; obtusa marginal &#91;OM1&#93; com estenose de 95&#37;&#41;&#46; Colocaram-se dois <span class="elsevierStyleItalic">stents</span> revestidos&#44; sem intercorr&#234;ncias&#46; Teve alta sob dupla antiagrega&#231;&#227;o &#40;&#225;cido acetilsalic&#237;lico 100 mg&#47;dia e clopidogrel 75 mg&#47;dia&#41; e restante terap&#234;utica dirigida &#224; doen&#231;a coron&#225;ria&#46; Recorreu ao servi&#231;o de urg&#234;ncia quatro horas ap&#243;s a alta por pr&#233;-cordialgia com irradia&#231;&#227;o ao membro superior esquerdo&#44; tendo-se diagnosticado enfarte agudo do mioc&#225;rdio com supradesnivelamento do segmento ST nas deriva&#231;&#245;es inferiores&#46; Realizou coronariografia uma hora ap&#243;s o in&#237;cio da dor&#44; que revelou oclus&#227;o de ambos os <span class="elsevierStyleItalic">stents</span>&#46; A tomografia de coer&#234;ncia &#243;tica &#40;OCT&#41; revelou boa aposi&#231;&#227;o do <span class="elsevierStyleItalic">stent</span> na CD&#44; trombos <span class="elsevierStyleItalic">intra-stent</span> e dissec&#231;&#227;o com in&#237;cio na margem distal do <span class="elsevierStyleItalic">stent&#46;</span> Realizou-se angioplastia de ambas as art&#233;rias&#44; com sucesso&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A trombose aguda dos <span class="elsevierStyleItalic">stents</span> pode ser explicada pelo aumento do potencial tromb&#243;tico conferido pelo VIH e pela diabetes&#46; N&#227;o existem recomenda&#231;&#245;es espec&#237;ficas relativas &#224; TARV na preven&#231;&#227;o secund&#225;ria ap&#243;s SCA&#46; A abordagem multidisciplinar destes doentes &#233; essencial para a sua orienta&#231;&#227;o adequada&#46;</p></span>"
      ]
    ]
    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Carvalho AS&#44; Os&#243;rio Valente R&#44; Almeida Morais L&#44; Modas Daniel P&#44; S&#225; Carvalho R&#44; Ferreira L&#44; et al&#46; VIH e doen&#231;a coron&#225;ria &#8211; quando a preven&#231;&#227;o secund&#225;ria &#233; insuficiente&#46; Rev Port Cardiol&#46; 2017&#59;36&#58;569&#46;</p>"
      ]
      1 => array:3 [
        "etiqueta" => "1"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">These authors contributed equally to this work&#46;</p>"
        "identificador" => "fn0005"
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1396
            "Ancho" => 2334
            "Tamanyo" => 699503
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Admission electrocardiogram on second hospitalization&#44; showing sinus rhythm&#44; right bundle branch block&#44; ST elevation in leads DII&#44; DIII and aVF&#44; and ST depression in leads V1-V3&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 609
            "Ancho" => 1800
            "Tamanyo" => 112587
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; Stent thrombosis in the right coronary artery &#40;RCA&#41; &#40;arrow&#41;&#59; &#40;b&#41; intraluminal subtraction image suggestive of RCA dissection &#40;arrow&#41;&#59; &#40;c&#41; RCA after thrombus aspiration&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1153
            "Ancho" => 1800
            "Tamanyo" => 381786
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; Right coronary artery &#40;RCA&#41; dissection visible by optical coherence tomography &#40;OCT&#41;&#59; &#40;b&#41; and &#40;c&#41; intrastent thrombosis in RCA visible by OCT&#59; &#40;d-f&#41; intrastent view of the RCA by OCT after thrombus aspiration&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "fig0020"
        "etiqueta" => "Figure 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 1285
            "Ancho" => 1800
            "Tamanyo" => 305993
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; Stent thrombosis in the first marginal&#59; &#40;b&#41; first marginal after thrombus aspiration and stent placement&#59; &#40;c-e&#41; thrombus in the first marginal documented by optical coherence tomography&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:34 [
            0 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Available at&#58; <span class="elsevierStyleInterRef" id="intr0010" href="http://linkinghub.elsevier.com/retrieve/pii/S1413867013001542">http&#58;&#47;&#47;linkinghub&#46;elsevier&#46;com&#47;retrieve&#47;pii&#47;S1413867013001542</span>"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A literature review on cardiovascular risk in human immunodeficiency virus-infected patients&#58; implications for clinical management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;G&#46; Neto"
                            1 => "R&#46; Zwirtes"
                            2 => "C&#46; Brites"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.bjid.2013.05.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Braz J Infect Dis"
                        "fecha" => "2013"
                        "volumen" => "17"
                        "paginaInicial" => "691"
                        "paginaFinal" => "700"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23916459"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Available at&#58; <span class="elsevierStyleInterRef" id="intr0015" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4368980%26tool=pmcentrez%26rendertype=Abstract">http&#58;&#47;&#47;www&#46;pubmedcentral&#46;nih&#46;gov&#47;articlerender&#46;fcgi&#63;artid&#61;4368980&#38;tool&#61;pmcentrez&#38;rendertype&#61;Abstract</span>"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiovascular disease in HIV patients&#58; from bench to bedside and backwards"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "E&#46; Cerrato"
                            1 => "A&#46; Calcagno"
                            2 => "F&#46; D&#8217;Ascenzo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/openhrt-2014-000174"
                      "Revista" => array:5 [
                        "tituloSerie" => "Open Heart"
                        "fecha" => "2015"
                        "volumen" => "2"
                        "paginaInicial" => "e000174"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25815207"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiovascular disease in patients with chronic human immunodeficiency virus infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46;O&#46; Esc&#225;rcega"
                            1 => "J&#46;J&#46; Franco"
                            2 => "B&#46;C&#46; Mani"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijcard.2014.04.155"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Cardiol"
                        "fecha" => "2014"
                        "volumen" => "175"
                        "paginaInicial" => "1"
                        "paginaFinal" => "7"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24798779"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factors associated with specific causes of death amongst HIV-positive individuals in the D&#58;A&#58;D Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:4 [
                            0 => "Data Collection On Adverse Events Of Anti-HIV drugs &#40;D&#58;A&#58;D&#41; Study Group"
                            1 => "C&#46; Smith"
                            2 => "C&#46; Sabin"
                            3 => "J&#46; Lundgren"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/QAD.0b013e32833a0918"
                      "Revista" => array:6 [
                        "tituloSerie" => "AIDS"
                        "fecha" => "2010"
                        "volumen" => "24"
                        "paginaInicial" => "1537"
                        "paginaFinal" => "1548"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20453631"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mortality in the highly active antiretroviral therapy era&#58; changing causes of death and disease in the HIV outpatient study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "F&#46;J&#46; Palella Jr&#46;"
                            1 => "R&#46;K&#46; Baker"
                            2 => "A&#46;C&#46; Moorman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.qai.0000233310.90484.16"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Acquir Immune Defic Syndr"
                        "fecha" => "2006"
                        "volumen" => "43"
                        "paginaInicial" => "27"
                        "paginaFinal" => "34"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16878047"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Causes of death in HIV-1-infected patients treated with antiretroviral therapy&#44; 1996-2006&#58; collaborative analysis of 13 HIV cohort studies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Antiretroviral Therapy Cohort Collaboration"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/652283"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "2010"
                        "volumen" => "50"
                        "paginaInicial" => "1387"
                        "paginaFinal" => "1396"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20380565"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trends in underlying causes of death in people with HIV from 1999 to 2011 &#40;D&#58;A&#58;D&#41;&#58; a multicohort collaboration"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46;J&#46; Smith"
                            1 => "L&#46; Ryom"
                            2 => "R&#46; Weber"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(14)60604-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2014"
                        "volumen" => "384"
                        "paginaInicial" => "241"
                        "paginaFinal" => "248"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25042234"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Increased acute myocardial infarction rates and cardiovascular risk factors among patients with human immunodeficiency virus disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "V&#46;A&#46; Trian"
                            1 => "H&#46; Lee"
                            2 => "C&#46; Hadigan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jc.2006-2190"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2007"
                        "volumen" => "92"
                        "paginaInicial" => "2506"
                        "paginaFinal" => "2512"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17456578"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "HIV infection and the risk of acute myocardial infarction"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46;S&#46; Freiberg"
                            1 => "C&#46;C&#46;H&#46; Chang"
                            2 => "L&#46;H&#46; Kuller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jamainternmed.2013.3728"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA Intern Med"
                        "fecha" => "2013"
                        "volumen" => "173"
                        "paginaInicial" => "614"
                        "paginaFinal" => "622"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23459863"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Percutaneous coronary intervention in HIV infected patients&#58; immediate results and long term prognosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "F&#46; Boccara"
                            1 => "E&#46; Teiger"
                            2 => "A&#46; Cohen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/hrt.2005.068445"
                      "Revista" => array:6 [
                        "tituloSerie" => "Heart"
                        "fecha" => "2006"
                        "volumen" => "92"
                        "paginaInicial" => "543"
                        "paginaFinal" => "544"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16537777"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outcomes after acute myocardial infarction in HIV-infected patients&#58; analysis of data from a French nationwide hospital medical information database"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "L&#46; Lorgis"
                            1 => "J&#46; Cottenet"
                            2 => "G&#46; Molins"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.113.001874"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2013"
                        "volumen" => "127"
                        "paginaInicial" => "1767"
                        "paginaFinal" => "1774"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23543004"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Safety and long-term outcomes after percutaneous coronary intervention in patients with human immunodeficiency virus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46; Badr"
                            1 => "S&#46; Minha"
                            2 => "H&#46; Kitabata"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/ccd.25466"
                      "Revista" => array:6 [
                        "tituloSerie" => "Catheter Cardiovasc Interv"
                        "fecha" => "2015"
                        "volumen" => "85"
                        "paginaInicial" => "192"
                        "paginaFinal" => "198"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24585520"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of risk factors for cardiovascular disease in HIV-infected patients over time&#58; the Swiss HIV Cohort Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46;R&#46; Glass"
                            1 => "C&#46; Ungsedhapand"
                            2 => "M&#46; Wolbers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1468-1293.2006.00400.x"
                      "Revista" => array:7 [
                        "tituloSerie" => "HIV Med"
                        "fecha" => "2006"
                        "volumen" => "7"
                        "paginaInicial" => "404"
                        "paginaFinal" => "410"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16903986"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1542356510011018"
                          "estado" => "S300"
                          "issn" => "15423565"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiovascular disease risk factors in HIV patients &#8211; association with antiretroviral therapy&#46; Results from the DAD study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "N&#46; Friis-M&#248;ller"
                            1 => "R&#46; Weber"
                            2 => "P&#46; Reiss"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.aids.0000060358.78202.c1"
                      "Revista" => array:7 [
                        "tituloSerie" => "AIDS"
                        "fecha" => "2003"
                        "volumen" => "17"
                        "paginaInicial" => "1179"
                        "paginaFinal" => "1193"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12819520"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673610605491"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antiretroviral therapy and the prevalence and incidence of diabetes mellitus in the multicenter AIDS cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46;T&#46; Brown"
                            1 => "S&#46;R&#46; Cole"
                            2 => "X&#46; Li"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archinte.165.10.1179"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Intern Med"
                        "fecha" => "2005"
                        "volumen" => "165"
                        "paginaInicial" => "1179"
                        "paginaFinal" => "1184"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15911733"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Inflammatory and coagulation biomarkers and mortality in patients with HIV infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "L&#46;H&#46; Kuller"
                            1 => "R&#46; Tracy"
                            2 => "W&#46; Belloso"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pmed.0050203"
                      "Revista" => array:5 [
                        "tituloSerie" => "PLoS Med"
                        "fecha" => "2008"
                        "volumen" => "5"
                        "paginaInicial" => "e203"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18942885"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "What a cardiologist needs to know about patients with human immunodeficiency virus infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46;Y&#46; Hsue"
                            1 => "D&#46;D&#46; Waters"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.105.546465"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2005"
                        "volumen" => "112"
                        "paginaInicial" => "3947"
                        "paginaFinal" => "3957"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16365213"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "HIV-associated dyslipidaemia&#58; pathogenesis and treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Oh"
                            1 => "R&#46;A&#46; Hegele"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1473-3099(07)70287-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet Infect Dis"
                        "fecha" => "2007"
                        "volumen" => "7"
                        "paginaInicial" => "787"
                        "paginaFinal" => "796"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18045561"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cytokines in atherosclerosis&#58; pathogenic and regulatory pathways"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Tedgui"
                            1 => "Z&#46; Mallat"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1152/physrev.00024.2005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Physiol Rev"
                        "fecha" => "2006"
                        "volumen" => "86"
                        "paginaInicial" => "515"
                        "paginaFinal" => "581"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16601268"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High prevalence at computed coronary tomography of non-calcified plaques in asymptomatic HIV patients treated with HAART&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "F&#46; D&#8217;Ascenzo"
                            1 => "E&#46; Cerrato"
                            2 => "A&#46; Calcagno"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.atherosclerosis.2015.03.019"
                      "Revista" => array:6 [
                        "tituloSerie" => "Atherosclerosis"
                        "fecha" => "2015"
                        "volumen" => "240"
                        "paginaInicial" => "197"
                        "paginaFinal" => "204"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25797313"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnosis&#44; prediction&#44; and natural course of HIV-1 protease-inhibitor-associated lipodystrophy&#44; hyperlipidaemia&#44; and diabetes mellitus&#58; a cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46; Carr"
                            1 => "K&#46; Samaras"
                            2 => "A&#46; Thorisdottir"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(98)08468-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1999"
                        "volumen" => "353"
                        "paginaInicial" => "2093"
                        "paginaFinal" => "2099"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10382692"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "HIV lipodystrophy&#58; risk factors&#44; pathogenesis&#44; diagnosis and management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46; Carr"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "AIDS"
                        "fecha" => "2003"
                        "volumen" => "17"
                        "paginaInicial" => "S141"
                        "paginaFinal" => "S148"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12870540"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0213005X12004521"
                          "estado" => "S300"
                          "issn" => "0213005X"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk of premature atherosclerosis and ischemic heart disease associated with HIV infection and antiretroviral therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "L&#46; Calza"
                            1 => "R&#46; Manfredi"
                            2 => "D&#46; Pocaterra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jinf.2008.02.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Infect"
                        "fecha" => "2008"
                        "volumen" => "57"
                        "paginaInicial" => "16"
                        "paginaFinal" => "32"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18358535"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk of myocardial infarction in patients with HIV infection exposed to specific individual antiretroviral drugs from the 3 major drug classes&#58; the data collection on adverse events of anti-HIV drugs &#40;D&#58;A&#58;D&#41; study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46;W&#46; Worm"
                            1 => "C&#46; Sabin"
                            2 => "R&#46; Weber"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/649897"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Infect Dis"
                        "fecha" => "2010"
                        "volumen" => "201"
                        "paginaInicial" => "318"
                        "paginaFinal" => "330"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20039804"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiovascular risks associated with abacavir and tenofovir exposure in HIV-infected persons"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;I&#46; Choi"
                            1 => "E&#46; Vittinghoff"
                            2 => "S&#46;G&#46; Deeks"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/QAD.0b013e328347fa16"
                      "Revista" => array:5 [
                        "tituloSerie" => "AIDS"
                        "fecha" => "2011"
                        "volumen" => "25"
                        "paginaInicial" => "1289"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21516027"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "No risk of myocardial infarction associated with initial antiretroviral treatment containing abacavir&#58; short and long-term results from ACTG A5001&#47;ALLRT"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;H&#46; Ribaudo"
                            1 => "A&#46;B&#46; Constance"
                            2 => "Y&#46; Zheng"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/cid/ciq244"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "2011"
                        "volumen" => "52"
                        "paginaInicial" => "929"
                        "paginaFinal" => "940"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21427402"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk of myocardial infarction and abacavir therapy&#58; no increased risk across 52 GlaxoSmithKline-sponsored clinical trials in adult subjects"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46; Brothers"
                            1 => "J&#46; Hernandez"
                            2 => "A&#46; Cutrell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/QAI.0b013e31819ff0e6"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Acquir Immune Defic Syndr"
                        "fecha" => "2009"
                        "volumen" => "51"
                        "paginaInicial" => "20"
                        "paginaFinal" => "28"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19282778"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is there continued evidence for an association between abacavir usage and myocardial infarction risk in individuals with HIV&#63; A cohort collaboration"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46;A&#46; Sabin"
                            1 => "P&#46; Reiss"
                            2 => "L&#46; Ryom"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s12916-015-0545-7"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Med"
                        "fecha" => "2016"
                        "volumen" => "14"
                        "paginaInicial" => "1"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26728489"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of in-hospital mortality from acute myocardial infarction in HIV sero-positive versus sero-negative individuals"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "D&#46; Pearce"
                            1 => "C&#46; Ani"
                            2 => "Y&#46; Espinosa-Silva"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjcard.2012.05.045"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "2012"
                        "volumen" => "110"
                        "paginaInicial" => "1078"
                        "paginaFinal" => "1084"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22762716"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outcome of percutaneous coronary intervention in HIV-infected patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Segev"
                            1 => "W&#46;J&#46; Cantor"
                            2 => "B&#46;H&#46; Strauss"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/ccd.20774"
                      "Revista" => array:6 [
                        "tituloSerie" => "Catheter Cardiovasc Interv"
                        "fecha" => "2006"
                        "volumen" => "68"
                        "paginaInicial" => "879"
                        "paginaFinal" => "881"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17086530"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiovascular disease in HIV infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "I&#46; Sudano"
                            1 => "L&#46;E&#46; Spieker"
                            2 => "G&#46; Noll"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ahj.2005.07.030"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Heart J"
                        "fecha" => "2006"
                        "volumen" => "151"
                        "paginaInicial" => "1147"
                        "paginaFinal" => "1155"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16781213"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical features of acute coronary syndromes in patients with human immunodeficiency virus infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "P&#46;Y&#46; Hsue"
                            1 => "K&#46; Giri"
                            2 => "S&#46; Erickson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/01.CIR.0000114520.38748.AA"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2004"
                        "volumen" => "109"
                        "paginaInicial" => "316"
                        "paginaFinal" => "319"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14718406"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Markers of inflammation and coagulation indicate a prothrombotic state in HIV-infected patients with long-term use of antiretroviral therapy with or without abacavir"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "E&#46; Jong"
                            1 => "J&#46;C&#46; Meijers"
                            2 => "E&#46;C&#46; Van Gorp"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1742-6405-7-1"
                      "Revista" => array:6 [
                        "tituloSerie" => "AIDS Res Ther"
                        "fecha" => "2010"
                        "volumen" => "7"
                        "paginaInicial" => "1"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20051116"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S147330991170007X"
                          "estado" => "S300"
                          "issn" => "14733099"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Thrombosis and a hypercoagulable state in HIV-infected patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "Y&#46;M&#46;P&#46; Shen"
                            1 => "E&#46;P&#46; Frenkel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Appl Thromb"
                        "fecha" => "2004"
                        "volumen" => "10"
                        "paginaInicial" => "277"
                        "paginaFinal" => "280"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21742049/0000003600000078/v1_201707290050/S2174204917301629/v1_201707290050/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9919"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Case Reports"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003600000078/v1_201707290050/S2174204917301629/v1_201707290050/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917301629?idApp=UINPBA00004E"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Case report
HIV and coronary disease – When secondary prevention is insufficient
VIH e doença coronária – quando a prevenção secundária é insuficiente
Ana Sofia Carvalhoa,1,
Corresponding author
asofia.dc@gmail.com

Corresponding author.
, Rui Osório Valenteb,1, Luís Almeida Moraisc, Pedro Modas Danielc, Ramiro Sá Carvalhoc, Lurdes Ferreirac, Rui Cruz Ferreirac
a Serviço de Medicina Interna, Hospital Egas Moniz Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
b Serviço de Medicina Interna, Hospital Beatriz Ângelo, Loures, Portugal
c Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal
Read
7284
Times
was read the article
2066
Total PDF
5218
Total HTML
Share statistics
 array:25 [
  "pii" => "S2174204917301629"
  "issn" => "21742049"
  "doi" => "10.1016/j.repce.2016.10.019"
  "estado" => "S300"
  "fechaPublicacion" => "2017-07-01"
  "aid" => "996"
  "copyright" => "Sociedade Portuguesa de Cardiologia"
  "copyrightAnyo" => "2017"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "crp"
  "cita" => "Rev Port Cardiol. 2017;36:569&#46;e1-8"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 3190
    "formatos" => array:3 [
      "EPUB" => 147
      "HTML" => 2569
      "PDF" => 474
    ]
  ]
  "Traduccion" => array:1 [
    "pt" => array:20 [
      "pii" => "S087025511730286X"
      "issn" => "08702551"
      "doi" => "10.1016/j.repc.2016.10.009"
      "estado" => "S300"
      "fechaPublicacion" => "2017-07-01"
      "aid" => "996"
      "copyright" => "Sociedade Portuguesa de Cardiologia"
      "documento" => "simple-article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "crp"
      "cita" => "Rev Port Cardiol. 2017;36:569&#46;e1-8"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 4376
        "formatos" => array:3 [
          "EPUB" => 209
          "HTML" => 3694
          "PDF" => 473
        ]
      ]
      "pt" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Caso cl&#237;nico</span>"
        "titulo" => "VIH e doen&#231;a coron&#225;ria &#8211; quando a preven&#231;&#227;o secund&#225;ria &#233; insuficiente"
        "tienePdf" => "pt"
        "tieneTextoCompleto" => "pt"
        "tieneResumen" => array:2 [
          0 => "pt"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "569&#46;e1"
            "paginaFinal" => "569&#46;e8"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "HIV and coronary disease &#8211; When secondary prevention is insufficient"
          ]
        ]
        "contieneResumen" => array:2 [
          "pt" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "pt" => true
        ]
        "contienePdf" => array:1 [
          "pt" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0010"
            "etiqueta" => "Figura 2"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr2.jpeg"
                "Alto" => 609
                "Ancho" => 1800
                "Tamanyo" => 111660
              ]
            ]
            "descripcion" => array:1 [
              "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">a&#41; Trombose de <span class="elsevierStyleItalic">stent</span> na CD &#40;seta&#41;&#59; b&#41; imagem de subtra&#231;&#227;o intraluminal sugestiva de dissec&#231;&#227;o da CD &#40;seta&#41;&#59; c&#41; CD p&#243;s aspira&#231;&#227;o de trombos&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Ana Sofia Carvalho, Rui Os&#243;rio Valente, Lu&#237;s Almeida Morais, Pedro Modas Daniel, Ramiro S&#225; Carvalho, Lurdes Ferreira, Rui Cruz Ferreira"
            "autores" => array:7 [
              0 => array:2 [
                "nombre" => "Ana Sofia"
                "apellidos" => "Carvalho"
              ]
              1 => array:2 [
                "nombre" => "Rui"
                "apellidos" => "Os&#243;rio Valente"
              ]
              2 => array:2 [
                "nombre" => "Lu&#237;s"
                "apellidos" => "Almeida Morais"
              ]
              3 => array:2 [
                "nombre" => "Pedro"
                "apellidos" => "Modas Daniel"
              ]
              4 => array:2 [
                "nombre" => "Ramiro"
                "apellidos" => "S&#225; Carvalho"
              ]
              5 => array:2 [
                "nombre" => "Lurdes"
                "apellidos" => "Ferreira"
              ]
              6 => array:2 [
                "nombre" => "Rui"
                "apellidos" => "Cruz Ferreira"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "pt"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2174204917301629"
          "doi" => "10.1016/j.repce.2016.10.019"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917301629?idApp=UINPBA00004E"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087025511730286X?idApp=UINPBA00004E"
      "url" => "/08702551/0000003600000078/v1_201707241250/S087025511730286X/v1_201707241250/pt/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S2174204917301617"
    "issn" => "21742049"
    "doi" => "10.1016/j.repce.2017.06.001"
    "estado" => "S300"
    "fechaPublicacion" => "2017-07-01"
    "aid" => "965"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "crp"
    "cita" => "Rev Port Cardiol. 2017;36:571&#46;e1-4"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2983
      "formatos" => array:3 [
        "EPUB" => 198
        "HTML" => 2319
        "PDF" => 466
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>"
      "titulo" => "Late incidental diagnosis of intrapericardial teratoma &#8211; A case report"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "571&#46;e1"
          "paginaFinal" => "571&#46;e4"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Diagn&#243;stico incidental tardio de teratoma intraperic&#225;rdico &#8211; relato de caso"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 657
              "Ancho" => 1600
              "Tamanyo" => 83197
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Cardiac magnetic resonance imaging with double inversion recovery &#40;A&#41; and double inversion recovery with fat saturation &#40;B&#41;&#44; showing areas of hyperintensity and hyposignal suggesting possible liquid&#44; fat or bloody&#47;high-protein components inside the compartments of the complex pericardial cyst&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Annelisa Moura Garcia, Roberto Nery Dantas Junior, Chang K&#46; Chi, Jos&#233; Rodrigues Parga"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Annelisa"
              "apellidos" => "Moura Garcia"
            ]
            1 => array:2 [
              "nombre" => "Roberto"
              "apellidos" => "Nery Dantas Junior"
            ]
            2 => array:2 [
              "nombre" => "Chang K&#46;"
              "apellidos" => "Chi"
            ]
            3 => array:2 [
              "nombre" => "Jos&#233;"
              "apellidos" => "Rodrigues Parga"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "pt" => array:9 [
        "pii" => "S0870255117301282"
        "doi" => "10.1016/j.repc.2016.09.015"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "pt"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117301282?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917301617?idApp=UINPBA00004E"
    "url" => "/21742049/0000003600000078/v1_201707290050/S2174204917301617/v1_201707290050/en/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S2174204917302088"
    "issn" => "21742049"
    "doi" => "10.1016/j.repce.2017.05.008"
    "estado" => "S300"
    "fechaPublicacion" => "2017-07-01"
    "aid" => "1025"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "rev"
    "cita" => "Rev Port Cardiol. 2017;36:551-67"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 8347
      "formatos" => array:3 [
        "EPUB" => 240
        "HTML" => 7460
        "PDF" => 647
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Review Article</span>"
      "titulo" => "Aspirin and blood pressure&#58; Effects when used alone or in combination with antihypertensive drugs"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "551"
          "paginaFinal" => "567"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Aspirina e press&#227;o arterial&#58; efeitos do uso isolado ou em associa&#231;&#227;o com f&#225;rmacos anti-hipertensores"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0015"
          "etiqueta" => "Figure 3"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr3.jpeg"
              "Alto" => 2415
              "Ancho" => 3000
              "Tamanyo" => 447467
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Major protective effects of low-dose aspirin&#46; AA&#58; arachidonic acid&#59; ATL&#58; aspirin-triggered lipoxin&#59; COX-1&#58; cyclooxygenase-1&#59; COX-2&#58; cyclooxygenase-2&#59; eNOS&#58; endothelial nitric oxide synthase&#59; NO&#58; nitric oxide&#59; PD&#58; protectin&#59; Rvs&#58; resolvins&#59; TXA<span class="elsevierStyleInf">2</span>&#58; thromboxane A<span class="elsevierStyleInf">2</span>&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ana Catarina Costa, Marta Reina-Couto, Ant&#243;nio Albino-Teixeira, Teresa Sousa"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Ana Catarina"
              "apellidos" => "Costa"
            ]
            1 => array:2 [
              "nombre" => "Marta"
              "apellidos" => "Reina-Couto"
            ]
            2 => array:2 [
              "nombre" => "Ant&#243;nio"
              "apellidos" => "Albino-Teixeira"
            ]
            3 => array:2 [
              "nombre" => "Teresa"
              "apellidos" => "Sousa"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0870255117302895"
        "doi" => "10.1016/j.repc.2017.05.008"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117302895?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917302088?idApp=UINPBA00004E"
    "url" => "/21742049/0000003600000078/v1_201707290050/S2174204917302088/v1_201707290050/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>"
    "titulo" => "HIV and coronary disease &#8211; When secondary prevention is insufficient"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "569&#46;e1"
        "paginaFinal" => "569&#46;e8"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Ana Sofia Carvalho, Rui Os&#243;rio Valente, Lu&#237;s Almeida Morais, Pedro Modas Daniel, Ramiro S&#225; Carvalho, Lurdes Ferreira, Rui Cruz Ferreira"
        "autores" => array:7 [
          0 => array:4 [
            "nombre" => "Ana Sofia"
            "apellidos" => "Carvalho"
            "email" => array:1 [
              0 => "asofia&#46;dc&#64;gmail&#46;com"
            ]
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "fn0005"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Rui"
            "apellidos" => "Os&#243;rio Valente"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "fn0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Lu&#237;s"
            "apellidos" => "Almeida Morais"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Pedro"
            "apellidos" => "Modas Daniel"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Ramiro"
            "apellidos" => "S&#225; Carvalho"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Lurdes"
            "apellidos" => "Ferreira"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Rui"
            "apellidos" => "Cruz Ferreira"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Servi&#231;o de Medicina Interna&#44; Hospital Egas Moniz Centro Hospitalar de Lisboa Ocidental&#44; Lisboa&#44; Portugal"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servi&#231;o de Medicina Interna&#44; Hospital Beatriz &#194;ngelo&#44; Loures&#44; Portugal"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Servi&#231;o de Cardiologia&#44; Hospital de Santa Marta&#44; Centro Hospitalar Lisboa Central&#44; Lisboa&#44; Portugal"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "VIH e doen&#231;a coron&#225;ria &#8211; quando a preven&#231;&#227;o secund&#225;ria &#233; insuficiente"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1153
            "Ancho" => 1800
            "Tamanyo" => 381786
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; Right coronary artery &#40;RCA&#41; dissection visible by optical coherence tomography &#40;OCT&#41;&#59; &#40;b&#41; and &#40;c&#41; intrastent thrombosis in RCA visible by OCT&#59; &#40;d-f&#41; intrastent view of the RCA by OCT after thrombus aspiration&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The advent of highly active antiretroviral therapy &#40;HAART&#41; has led to a marked decrease in morbidity and mortality among patients with human immunodeficiency virus &#40;HIV&#41; infection&#44;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">1&#8211;4</span></a> and a consequent increase in their life expectancy and in the prevalence of chronic diseases not previously associated with HIV&#46; These include cardiovascular and liver disease and cancer&#44;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">5&#8211;7</span></a> the treatment of which is becoming increasingly important in these patients&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">There is in fact a well-documented higher risk of coronary artery disease &#40;CAD&#41; in HIV patients compared to the general population&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">3&#44;8&#44;9</span></a> In a study carried out by the Antiretroviral Therapy Cohort Collaboration&#44;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">6</span></a> which included 39<span class="elsevierStyleHsp" style=""></span>272 patients from 13 cohorts of patients receiving HAART between 1996 and 2006 in Europe and the USA&#44; mortality attributed to cardiovascular disease in HIV patients was 7&#46;9&#37; &#40;40&#37; of which was due to CAD or myocardial infarction &#91;MI&#93; and 18&#37; to stroke&#41;&#46; The D&#58;A&#58;D study&#44;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">7</span></a> which was completed later and included 49<span class="elsevierStyleHsp" style=""></span>731 patients followed between 1999 and 2011 in clinics in Europe&#44; the USA and Australia&#44; reported mortality of 11&#37; due to cardiovascular disease&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">There are few data on the risk of adverse cardiovascular events in HIV-infected patients undergoing percutaneous coronary intervention &#40;PCI&#41; with drug-eluting stents in the context of acute coronary syndrome &#40;ACS&#41;&#46; Some studies<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">10&#8211;12</span></a> have reported similar rates for infected and non-infected patients&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">We report the case of an HIV patient with diabetes who presented acute thrombosis of drug-eluting stents in two different coronary arteries four hours after hospital discharge&#44; which manifested as ST-elevation MI&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">An unusual case of acute stent thrombosis in an HIV patient is presented&#44; together with a literature review and discussion of possible explanations for this atypical presentation&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Case report</span><p id="par0030" class="elsevierStylePara elsevierViewall">A 57-year-old man&#44; black&#44; born in Guinea and resident in Portugal since 1982&#44; an astrologer&#44; had a personal history of co-infection with HIV-2 and hepatitis B virus &#40;HBV&#41;&#46; HIV-2 was diagnosed in 1997 &#40;19 years before this hospitalization&#41;&#44; when HAART was begun&#46; The patient&#39;s CD4&#43; T cell count before therapy is unknown&#46; He was regularly monitored and complied with therapy&#44; which included the antiretrovirals lamivudine&#44; stavudine&#44; indinavir and abacavir&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The patient&#39;s viral load and CD4&#43; T cell count were generally under control from the time of diagnosis&#44; except for a period of one year approximately two years before this admission&#44; when he presented an increased viral load &#40;maximum 4500 copies&#47;ml&#44; although his CD4&#43; T cell count was controlled throughout this period&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">At admission&#44; the patient was under combined HAART&#44; namely tenofovir and emtricitabine 300 mg&#47;200 mg once daily&#59; darunavir in combination with ritonavir 600 mg&#47;100 mg twice daily and raltegravir 400 mg twice daily&#46; He presented adequate CD4&#43; T cell counts and negative viral load&#46; HBV infection was diagnosed in 2010 &#40;six years before this hospitalization&#41;&#44; and regular monitoring continued to show negative viral load under tenofovir therapy&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">He had a history of insulin-treated type 2 diabetes&#44; diagnosed 17 years prior to this admission&#44; with no known microvascular complications&#44; and mixed dyslipidemia &#40;predominantly hypertriglyceridemia&#41;&#44; diagnosed 10 years previously&#46; Laboratory tests at the time of diagnosis showed total cholesterol 205 mg&#47;dl&#44; high density lipoprotein &#40;HDL&#41; cholesterol 21 mg&#47;dl&#44; low density lipoprotein &#40;LDL&#41; cholesterol 90 mg&#47;dl&#44; and triglycerides 265 mg&#47;dl&#46; Therapy with fenofibrate 145 mg&#47;daily was begun&#44; which the patient had continued ever since&#46; Persistently high total and LDL cholesterol levels during follow-up led to atorvastatin 20 mg being added around four years previously&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The patient had no other risk factors&#44; including smoking&#44; cocaine use&#44; hypertension&#44; obesity or family history of sudden death&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Besides HAART&#44; he was thus being medicated as an outpatient with atorvastatin 20 mg&#44; fenofibrate 145 mg&#44; pantoprazole 20 mg&#44; linagliptin 5 mg and insulin &#40;Insulatard<span class="elsevierStyleSup">&#174;</span>&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The patient went to the emergency department &#40;ED&#41; due to right chest pain radiating to the neck that had begun that morning as soon as he arose&#44; not associated with effort and with no aggravating or alleviating factors&#46; He reported no respiratory or gastrointestinal problems&#44; fever or history of trauma&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Physical examination on admission to the ED revealed no significant alterations&#46; Diagnostic exams included an ECG&#44; which showed sinus rhythm and right bundle branch block &#40;RBBB&#41;&#44; but no ST-segment changes&#46; Laboratory tests revealed hemoglobin 11&#46;5 g&#47;dl&#44; sodium 134 mmol&#47;l&#44; potassium 4&#46;6 mmol&#47;l&#44; chloride 100 mmol&#47;l&#44; urea 56 mg&#47;dl&#44; creatinine 1&#46;46 mg&#47;dl &#40;estimated glomerular filtration rate 61 ml&#47;min&#47;1&#46;73 m<span class="elsevierStyleSup">2</span> according to the Chronic Kidney Disease Epidemiology Collaboration equation&#41;&#44; and increased myocardial necrosis markers &#40;high-sensitivity troponin I 348&#46;5 &#956;g&#47;l at first assessment and 392&#46;2 &#956;g&#47;l at second assessment&#44; a rise of 13&#37;&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">A diagnosis of non-ST elevation MI was made&#44; a loading dose of dual antiplatelet therapy &#40;aspirin and clopidogrel&#41; was administered and the patient was admitted&#46; He presented no further episodes of chest pain&#44; myocardial necrosis markers fell from 409&#46;9 &#956;g&#47;l &#40;peak&#41; to 78&#46;2 &#956;g&#47;l and there were no new ECG alterations&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Coronary angiography on the fourth day of hospital stay showed two-vessel disease &#40;90&#37; stenosis of the mid segment of the right coronary artery &#91;RCA&#93;&#44; and 95&#37; stenosis of the first marginal&#41;&#44; and two drug-eluting stents were successfully implanted&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">The patient remained hemodynamically stable under dual antiplatelet therapy &#40;aspirin 100 mg&#47;daily and clopidogrel 75 mg&#47;daily&#41; and high-dose statin therapy &#40;atorvastatin 40 mg&#41;&#46; Bisoprolol and lisinopril were also started during hospital stay&#46; The patient also received the same antiretroviral therapy he had been receiving as an outpatient&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Laboratory tests during hospitalization showed poor metabolic control&#44; with glycosylated hemoglobin 9&#46;2&#37; &#40;7&#46;0&#37; three months previously&#41; and undetectable HBV and HIV-2 viral loads&#46; The patient&#39;s lipid profile at admission was total cholesterol 142 mg&#47;dl&#44; HDL cholesterol 18 mg&#47;dl&#44; LDL cholesterol 52 mg&#47;dl &#40;by direct measurement&#41;&#44; and triglycerides 326 mg&#47;dl&#46; Testing for thrombophilia included measurement of protein S&#44; protein C&#44; homocysteine&#44; factor V Leiden&#44; antithrombin and von Willebrand factor&#44; all of which were within the reference range&#59; screening for anti-nuclear antibodies and lupus anticoagulant was also negative&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">The patient was discharged on the 11th day of hospitalization&#44; under the medication described above and maintaining the antiretroviral therapy he was receiving at admission&#46; There were no further complications&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">He returned to the ED four hours after discharge&#44; due to chest pain radiating to his left arm&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">The ECG showed sinus rhythm&#44; RBBB and ST elevation in leads DII&#44; DIII&#44; and aVF and ST depression in leads V1-V3 &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">Coronary angiography was performed within an hour of pain onset&#44; and revealed occlusion of both stents &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>a and b&#41;&#46; Optical coherence tomography &#40;OCT&#41; of the two arteries was performed to clarify the situation&#46; OCT of the RCA showed good stent apposition&#44; intrastent thrombus and dissection beginning at the distal margin of the stent &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>a-c&#41;&#44; while OCT of the first marginal showed good apposition and intrastent thrombi but no dissection &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Figure 4</a>a&#44; c-e&#41;&#46; Angioplasty of the mid segment of the RCA was then performed&#44; and a stent was implanted after thrombus aspiration &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>d-f&#41;&#44; as well as balloon angioplasty of the first marginal after thrombus aspiration &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Figure 4</a>b&#41;&#46; There was a good final result&#44; TIMI 3 flow being re-established in both arteries&#46; A glycoprotein IIb&#47;IIIa inhibitor &#40;abciximab&#41; was administered&#44; due to the patient&#39;s high thrombotic burden&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">After the procedure it was decided to replace clopidogrel by ticagrelor&#46; The patient experienced no recurrence of pain or new ECG alterations during the rest of hospital stay&#46; He was discharged medicated with aspirin 100 mg once daily&#44; ticagrelor 90 mg twice daily&#44; bisoprolol 5 mg once daily and lisinopril 20 mg once daily&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">At the time this case report was prepared&#44; the patient had undergone cardiological assessment after four months of follow-up&#44; and no further ischemic complications were recorded&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0120" class="elsevierStylePara elsevierViewall">The increased life expectancy of HIV-infected patients following the introduction of HAART has been accompanied by an increased prevalence of metabolic disorders&#44; which raises new problems for their management&#46;</p><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">HIV and the pathophysiology of cardiovascular disease</span><p id="par0125" class="elsevierStylePara elsevierViewall">Various factors are known to increase the risk of cardiovascular disease in HIV patients&#46; On one hand&#44; this population has a high prevalence of conventional risk factors&#44;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">13</span></a> particularly smoking&#44;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">13&#44;14</span></a> low HDL cholesterol&#44; hypertriglyceridemia and hypertension&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">13</span></a> Some studies<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">15</span></a> report that the incidence of diabetes in HIV patients exposed to HAART is four times higher that in seronegative patients&#46; On the other hand&#44; complex pathophysiological mechanisms related to the virus itself also play a part&#44; resulting from persistent immunodeficiency&#44; immune dysregulation&#44; immune activation and inflammation&#44;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">16</span></a> even in patients under HAART&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Endothelial dysfunction&#44; a key element of atherogenesis&#44; is the end result of various processes that coexist in the presence of HIV&#44; including direct and indirect endothelial injury &#40;via immune reactions or drugs&#41;&#44; destruction of CD4&#43; T cells &#40;accompanied by an increase in shed membrane particles that induce endothelial dysfunction&#41; and enhanced expression of adhesion molecules &#40;via increased cytokine activity or as a direct effect of the virus&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">17&#44;18</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">There is thus a persistent inflammatory state in these patients that results in vascular damage and premature atherosclerosis&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">19</span></a> Some studies have shown a significant increase in non-calcified plaques in HIV patients treated with HAART&#44; which may also be associated with cardiovascular events&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">20</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">An increased risk of CAD has also been demonstrated in HIV patients compared to the general population&#44; occurring at an earlier age<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">3</span></a> and with more aggressive characteristics &#40;greater prevalence of ST-elevation MI and multivessel involvement&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">2</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">In addition&#44; HAART also causes metabolic changes that further increase risk in these patients&#44; including metabolic syndrome&#44; characterized by dyslipidemia &#40;predominantly hypertriglyceridemia&#41; and insulin resistance&#44; frequently associated with abnormal fat distribution and lipodystrophy&#46;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">21&#44;22</span></a> This&#44; while HAART helps to reduce endothelial injury by controlling HIV infection&#44; it also activates the endothelium by interfering in glucose and lipid metabolism&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">23</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">Assessing the relationship between HAART and cardiovascular risk is complicated&#44; since the currently recommended combined therapy regimes include drugs of various classes&#44; making it difficult to draw reliable conclusions&#46; In addition&#44; many patients are medicated with different regimes over time&#44; due to therapeutic failure or adverse effects&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Data from the D&#58;A&#58;D study&#44;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">24</span></a> which analyzed the association between HAART and risk of MI&#44; showed that of the protease inhibitors&#44; only indinavir and lopinavir-ritonavir were associated with a significantly increased risk of MI&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">In the same cohort&#44; of nucleoside reverse transcriptase inhibitors&#44; only abacavir and didanosine were significantly associated with risk of MI&#46; There have been many studies on abacavir in particular&#44; but with conflicting results&#46; Some report an association between current or recent exposure to abacavir and increased risk of MI&#44;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">25</span></a> while others found no evidence of such an association&#46;<a class="elsevierStyleCrossRefs" href="#bib0300"><span class="elsevierStyleSup">26&#44;27</span></a> There is in fact no known biological mechanism to explain the association&#44; although experimental studies have suggested various potential explanations&#44; including endothelial dysfunction and the ability of abacavir to induce inflammation of the vascular wall by enhancing leukocyte attachment to endothelial cells&#44; and possibly to increase platelet activation&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">28</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Incidence of acute-phase reinfarction or restenosis in HIV patients</span><p id="par0165" class="elsevierStylePara elsevierViewall">The prognosis of HIV patients in the acute phase of ACS has been analyzed in only a small number of works&#46; A nationwide study in the USA between 1997 and 2006<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">29</span></a> found a higher rate of in-hospital mortality in HIV patients admitted with ACS &#40;with or without ST elevation&#41;&#44; although there were differences in the treatment offered in the seropositive and seronegative groups&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Some authors argue that HIV patients undergoing PCI present higher incidences of reinfarction&#44; restenosis and stent thrombosis as a result of their prothrombotic state&#44;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">2&#44;30&#44;31</span></a> although few other studies have demonstrated such an association&#46; Hsue et al&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">32</span></a> reported a higher restenosis rate after PCI in HIV-infected patients than in controls &#40;52&#37; vs&#46; 14&#37;&#44; p&#61;0&#46;006&#41;&#44; but other studies<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">10&#44;11</span></a> have reported similar rates of cardiovascular adverse events in patients with and without HIV infection undergoing PCI with drug-eluting stents in the context of ACS&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Given the higher prothrombotic risk of these patients&#44;<a class="elsevierStyleCrossRefs" href="#bib0335"><span class="elsevierStyleSup">33&#44;34</span></a> it is important to investigate whether there is in fact a relationship between HIV infection and risk of stent thrombosis&#46; In addition&#44; there have been no studies assessing the impact of a more aggressive approach to treating conventional risk factors in HIV patients with a view to reducing their cardiovascular risk&#46; Further studies are needed to increase our knowledge in areas such as reducing immune activation&#44; chronic inflammation and residual viremia&#44; and the possible relationship between antiretroviral therapy and stent thrombosis&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Particular aspects of the case reported</span><p id="par0180" class="elsevierStylePara elsevierViewall">In the case presented&#44; even though the patient had other cardiovascular risk factors&#44; HIV infection appears to be the main factor involved in stent thrombosis so soon after hospital discharge in an individual with optimized secondary prevention therapy&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">One possible explanation for stent thrombosis in the RCA would be dissection of the artery that had not been visualized on initial coronary angiography and that contributed to the thrombotic event&#44; since OCT revealed good apposition&#44; intrastent thrombus and dissection beginning at the distal margin of the stent&#46; Nevertheless&#44; this is highly unlikely&#44; since it does not explain thrombosis of two stents in different arteries&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">The factor that could explain acute thrombosis of both stents is therefore increased thrombotic risk conferred by HIV infection and by diabetes&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">There are no specific guidelines with regard to antiplatelet therapy in HIV-infected patients and the decision to replace clopidogrel by ticagrelor in this case was based not on evidence but on the failure of previous therapy&#46; It would be interesting to know whether the new P2Y12 inhibitors are more effective at secondary prevention of cardiovascular events in HIV patients&#44; and should therefore be used as first-line therapy&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusions</span><p id="par0200" class="elsevierStylePara elsevierViewall">The transformation of HIV infection from a disease with high short-term mortality to a chronic disease has raised new and pressing research questions regarding the cardiovascular risk of this population&#44; given their known risk profile&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">The current approach to reducing cardiovascular risk consists of early initiation of HAART and adequate control of conventional risk factors&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">However&#44; the case presented highlights the fact that adequate control of HIV infection and conventional risk factors may be insufficient&#44; and raises various questions that require thorough investigation&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">Finally&#44; a multidisciplinary approach will help in choosing the most appropriate care for these patients&#44; with emphasis on the role of the cardiologist&#44; infectologist and internist&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Ethical disclosures</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Protection of human and animal subjects</span><p id="par0220" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Confidentiality of data</span><p id="par0225" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Right to privacy and informed consent</span><p id="par0230" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conflicts of interest</span><p id="par0235" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres875797"
          "titulo" => "Abstract"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0005"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec863893"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres875798"
          "titulo" => "Resumo"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0010"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec863894"
          "titulo" => "Palavras-chave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Case report"
        ]
        6 => array:3 [
          "identificador" => "sec0015"
          "titulo" => "Discussion"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "HIV and the pathophysiology of cardiovascular disease"
            ]
            1 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Incidence of acute-phase reinfarction or restenosis in HIV patients"
            ]
            2 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Particular aspects of the case reported"
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Conclusions"
        ]
        8 => array:3 [
          "identificador" => "sec0040"
          "titulo" => "Ethical disclosures"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Protection of human and animal subjects"
            ]
            1 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Confidentiality of data"
            ]
            2 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Right to privacy and informed consent"
            ]
          ]
        ]
        9 => array:2 [
          "identificador" => "sec0060"
          "titulo" => "Conflicts of interest"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2016-04-06"
    "fechaAceptado" => "2016-10-03"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec863893"
          "palabras" => array:3 [
            0 => "Human immunodeficiency virus"
            1 => "Stent thrombosis"
            2 => "Coronary disease"
          ]
        ]
      ]
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras-chave"
          "identificador" => "xpalclavsec863894"
          "palabras" => array:3 [
            0 => "V&#237;rus da imunodefici&#234;ncia humana"
            1 => "Trombose de <span class="elsevierStyleItalic">stent</span>"
            2 => "Doen&#231;a coron&#225;ria"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Highly active antiretroviral therapy &#40;HAART&#41; has created a new paradigm for human immunodeficiency virus &#40;HIV&#41;-infected patients&#44; but their increased risk for coronary disease is well documented&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We present the case of a 57-year-old man&#44; co-infected with HIV-2 and hepatitis B virus&#44; adequately controlled and with insulin-treated type 2 diabetes and dyslipidemia&#44; who was admitted with non-ST elevation acute myocardial infarction&#46; Coronary angiography performed on day four of hospital stay documented two-vessel disease &#40;mid segment of the right coronary artery &#91;RCA&#44; 90&#37; stenosis&#93; and the first marginal&#41;&#46; Two drug-eluting stents were successfully implanted&#46; The patient was discharged under dual antiplatelet therapy &#40;aspirin 100 mg&#47;day and clopidogrel 75 mg&#47;day&#41; and standard coronary artery disease medication&#46; He was admitted to the emergency room four hours after discharge with chest pain radiating to the left arm and inferior ST-segment elevation myocardial infarction was diagnosed&#46; Coronary angiography was performed within one hour and documented thrombosis of both stents&#46; Optical coherence tomography revealed good apposition of the stent in the RCA&#44; with intrastent thrombus&#46; Angioplasty was performed&#44; with a good outcome&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The acute stent thrombosis might be explained by the thrombotic potential of HIV infection and diabetes&#46; There are no specific guidelines regarding HAART in secondary prevention of acute coronary syndromes&#46; A multidisciplinary approach is essential for optimal management of these patients&#46;</p></span>"
      ]
      "pt" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A terap&#234;utica antiretroviral &#40;TARV&#41; alterou o paradigma da infe&#231;&#227;o pelo v&#237;rus da imunodefici&#234;ncia humana &#40;VIH&#41;&#44; conhecendo-se o risco aumentado de doen&#231;a coron&#225;ria nestes doentes&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Apresenta-se o caso de um homem de 57 anos&#44; melanod&#233;rmico&#44; com coinfec&#231;&#227;o VIH-2&#47;v&#237;rus hepatite B&#44; com controlo adequado&#59; diabetes <span class="elsevierStyleItalic">mellitus</span> tipo 2&#44; insulino-tratado e dislipidemia&#46; Internado por enfarte agudo do mioc&#225;rdio&#44; sem supradesnivelamento ST&#46; Realizou cateterismo ao 4&#46;&#176; dia de internamento&#44; documentando-se doen&#231;a de dois vasos &#40;segmento m&#233;dio da coron&#225;ria direita &#91;CD&#93; &#91;90&#37; estenose&#93; e 1&#46;&#170; obtusa marginal &#91;OM1&#93; com estenose de 95&#37;&#41;&#46; Colocaram-se dois <span class="elsevierStyleItalic">stents</span> revestidos&#44; sem intercorr&#234;ncias&#46; Teve alta sob dupla antiagrega&#231;&#227;o &#40;&#225;cido acetilsalic&#237;lico 100 mg&#47;dia e clopidogrel 75 mg&#47;dia&#41; e restante terap&#234;utica dirigida &#224; doen&#231;a coron&#225;ria&#46; Recorreu ao servi&#231;o de urg&#234;ncia quatro horas ap&#243;s a alta por pr&#233;-cordialgia com irradia&#231;&#227;o ao membro superior esquerdo&#44; tendo-se diagnosticado enfarte agudo do mioc&#225;rdio com supradesnivelamento do segmento ST nas deriva&#231;&#245;es inferiores&#46; Realizou coronariografia uma hora ap&#243;s o in&#237;cio da dor&#44; que revelou oclus&#227;o de ambos os <span class="elsevierStyleItalic">stents</span>&#46; A tomografia de coer&#234;ncia &#243;tica &#40;OCT&#41; revelou boa aposi&#231;&#227;o do <span class="elsevierStyleItalic">stent</span> na CD&#44; trombos <span class="elsevierStyleItalic">intra-stent</span> e dissec&#231;&#227;o com in&#237;cio na margem distal do <span class="elsevierStyleItalic">stent&#46;</span> Realizou-se angioplastia de ambas as art&#233;rias&#44; com sucesso&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A trombose aguda dos <span class="elsevierStyleItalic">stents</span> pode ser explicada pelo aumento do potencial tromb&#243;tico conferido pelo VIH e pela diabetes&#46; N&#227;o existem recomenda&#231;&#245;es espec&#237;ficas relativas &#224; TARV na preven&#231;&#227;o secund&#225;ria ap&#243;s SCA&#46; A abordagem multidisciplinar destes doentes &#233; essencial para a sua orienta&#231;&#227;o adequada&#46;</p></span>"
      ]
    ]
    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Carvalho AS&#44; Os&#243;rio Valente R&#44; Almeida Morais L&#44; Modas Daniel P&#44; S&#225; Carvalho R&#44; Ferreira L&#44; et al&#46; VIH e doen&#231;a coron&#225;ria &#8211; quando a preven&#231;&#227;o secund&#225;ria &#233; insuficiente&#46; Rev Port Cardiol&#46; 2017&#59;36&#58;569&#46;</p>"
      ]
      1 => array:3 [
        "etiqueta" => "1"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">These authors contributed equally to this work&#46;</p>"
        "identificador" => "fn0005"
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1396
            "Ancho" => 2334
            "Tamanyo" => 699503
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Admission electrocardiogram on second hospitalization&#44; showing sinus rhythm&#44; right bundle branch block&#44; ST elevation in leads DII&#44; DIII and aVF&#44; and ST depression in leads V1-V3&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 609
            "Ancho" => 1800
            "Tamanyo" => 112587
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; Stent thrombosis in the right coronary artery &#40;RCA&#41; &#40;arrow&#41;&#59; &#40;b&#41; intraluminal subtraction image suggestive of RCA dissection &#40;arrow&#41;&#59; &#40;c&#41; RCA after thrombus aspiration&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1153
            "Ancho" => 1800
            "Tamanyo" => 381786
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; Right coronary artery &#40;RCA&#41; dissection visible by optical coherence tomography &#40;OCT&#41;&#59; &#40;b&#41; and &#40;c&#41; intrastent thrombosis in RCA visible by OCT&#59; &#40;d-f&#41; intrastent view of the RCA by OCT after thrombus aspiration&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "fig0020"
        "etiqueta" => "Figure 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 1285
            "Ancho" => 1800
            "Tamanyo" => 305993
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; Stent thrombosis in the first marginal&#59; &#40;b&#41; first marginal after thrombus aspiration and stent placement&#59; &#40;c-e&#41; thrombus in the first marginal documented by optical coherence tomography&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:34 [
            0 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Available at&#58; <span class="elsevierStyleInterRef" id="intr0010" href="http://linkinghub.elsevier.com/retrieve/pii/S1413867013001542">http&#58;&#47;&#47;linkinghub&#46;elsevier&#46;com&#47;retrieve&#47;pii&#47;S1413867013001542</span>"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A literature review on cardiovascular risk in human immunodeficiency virus-infected patients&#58; implications for clinical management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;G&#46; Neto"
                            1 => "R&#46; Zwirtes"
                            2 => "C&#46; Brites"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.bjid.2013.05.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Braz J Infect Dis"
                        "fecha" => "2013"
                        "volumen" => "17"
                        "paginaInicial" => "691"
                        "paginaFinal" => "700"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23916459"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Available at&#58; <span class="elsevierStyleInterRef" id="intr0015" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4368980%26tool=pmcentrez%26rendertype=Abstract">http&#58;&#47;&#47;www&#46;pubmedcentral&#46;nih&#46;gov&#47;articlerender&#46;fcgi&#63;artid&#61;4368980&#38;tool&#61;pmcentrez&#38;rendertype&#61;Abstract</span>"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiovascular disease in HIV patients&#58; from bench to bedside and backwards"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "E&#46; Cerrato"
                            1 => "A&#46; Calcagno"
                            2 => "F&#46; D&#8217;Ascenzo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/openhrt-2014-000174"
                      "Revista" => array:5 [
                        "tituloSerie" => "Open Heart"
                        "fecha" => "2015"
                        "volumen" => "2"
                        "paginaInicial" => "e000174"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25815207"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiovascular disease in patients with chronic human immunodeficiency virus infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46;O&#46; Esc&#225;rcega"
                            1 => "J&#46;J&#46; Franco"
                            2 => "B&#46;C&#46; Mani"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijcard.2014.04.155"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Cardiol"
                        "fecha" => "2014"
                        "volumen" => "175"
                        "paginaInicial" => "1"
                        "paginaFinal" => "7"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24798779"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factors associated with specific causes of death amongst HIV-positive individuals in the D&#58;A&#58;D Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:4 [
                            0 => "Data Collection On Adverse Events Of Anti-HIV drugs &#40;D&#58;A&#58;D&#41; Study Group"
                            1 => "C&#46; Smith"
                            2 => "C&#46; Sabin"
                            3 => "J&#46; Lundgren"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/QAD.0b013e32833a0918"
                      "Revista" => array:6 [
                        "tituloSerie" => "AIDS"
                        "fecha" => "2010"
                        "volumen" => "24"
                        "paginaInicial" => "1537"
                        "paginaFinal" => "1548"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20453631"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mortality in the highly active antiretroviral therapy era&#58; changing causes of death and disease in the HIV outpatient study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "F&#46;J&#46; Palella Jr&#46;"
                            1 => "R&#46;K&#46; Baker"
                            2 => "A&#46;C&#46; Moorman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.qai.0000233310.90484.16"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Acquir Immune Defic Syndr"
                        "fecha" => "2006"
                        "volumen" => "43"
                        "paginaInicial" => "27"
                        "paginaFinal" => "34"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16878047"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Causes of death in HIV-1-infected patients treated with antiretroviral therapy&#44; 1996-2006&#58; collaborative analysis of 13 HIV cohort studies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Antiretroviral Therapy Cohort Collaboration"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/652283"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "2010"
                        "volumen" => "50"
                        "paginaInicial" => "1387"
                        "paginaFinal" => "1396"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20380565"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trends in underlying causes of death in people with HIV from 1999 to 2011 &#40;D&#58;A&#58;D&#41;&#58; a multicohort collaboration"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46;J&#46; Smith"
                            1 => "L&#46; Ryom"
                            2 => "R&#46; Weber"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(14)60604-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2014"
                        "volumen" => "384"
                        "paginaInicial" => "241"
                        "paginaFinal" => "248"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25042234"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Increased acute myocardial infarction rates and cardiovascular risk factors among patients with human immunodeficiency virus disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "V&#46;A&#46; Trian"
                            1 => "H&#46; Lee"
                            2 => "C&#46; Hadigan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jc.2006-2190"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2007"
                        "volumen" => "92"
                        "paginaInicial" => "2506"
                        "paginaFinal" => "2512"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17456578"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "HIV infection and the risk of acute myocardial infarction"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46;S&#46; Freiberg"
                            1 => "C&#46;C&#46;H&#46; Chang"
                            2 => "L&#46;H&#46; Kuller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jamainternmed.2013.3728"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA Intern Med"
                        "fecha" => "2013"
                        "volumen" => "173"
                        "paginaInicial" => "614"
                        "paginaFinal" => "622"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23459863"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Percutaneous coronary intervention in HIV infected patients&#58; immediate results and long term prognosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "F&#46; Boccara"
                            1 => "E&#46; Teiger"
                            2 => "A&#46; Cohen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/hrt.2005.068445"
                      "Revista" => array:6 [
                        "tituloSerie" => "Heart"
                        "fecha" => "2006"
                        "volumen" => "92"
                        "paginaInicial" => "543"
                        "paginaFinal" => "544"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16537777"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outcomes after acute myocardial infarction in HIV-infected patients&#58; analysis of data from a French nationwide hospital medical information database"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "L&#46; Lorgis"
                            1 => "J&#46; Cottenet"
                            2 => "G&#46; Molins"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.113.001874"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2013"
                        "volumen" => "127"
                        "paginaInicial" => "1767"
                        "paginaFinal" => "1774"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23543004"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Safety and long-term outcomes after percutaneous coronary intervention in patients with human immunodeficiency virus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46; Badr"
                            1 => "S&#46; Minha"
                            2 => "H&#46; Kitabata"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/ccd.25466"
                      "Revista" => array:6 [
                        "tituloSerie" => "Catheter Cardiovasc Interv"
                        "fecha" => "2015"
                        "volumen" => "85"
                        "paginaInicial" => "192"
                        "paginaFinal" => "198"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24585520"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of risk factors for cardiovascular disease in HIV-infected patients over time&#58; the Swiss HIV Cohort Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46;R&#46; Glass"
                            1 => "C&#46; Ungsedhapand"
                            2 => "M&#46; Wolbers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1468-1293.2006.00400.x"
                      "Revista" => array:7 [
                        "tituloSerie" => "HIV Med"
                        "fecha" => "2006"
                        "volumen" => "7"
                        "paginaInicial" => "404"
                        "paginaFinal" => "410"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16903986"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1542356510011018"
                          "estado" => "S300"
                          "issn" => "15423565"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiovascular disease risk factors in HIV patients &#8211; association with antiretroviral therapy&#46; Results from the DAD study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "N&#46; Friis-M&#248;ller"
                            1 => "R&#46; Weber"
                            2 => "P&#46; Reiss"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.aids.0000060358.78202.c1"
                      "Revista" => array:7 [
                        "tituloSerie" => "AIDS"
                        "fecha" => "2003"
                        "volumen" => "17"
                        "paginaInicial" => "1179"
                        "paginaFinal" => "1193"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12819520"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673610605491"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antiretroviral therapy and the prevalence and incidence of diabetes mellitus in the multicenter AIDS cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46;T&#46; Brown"
                            1 => "S&#46;R&#46; Cole"
                            2 => "X&#46; Li"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archinte.165.10.1179"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Intern Med"
                        "fecha" => "2005"
                        "volumen" => "165"
                        "paginaInicial" => "1179"
                        "paginaFinal" => "1184"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15911733"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Inflammatory and coagulation biomarkers and mortality in patients with HIV infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "L&#46;H&#46; Kuller"
                            1 => "R&#46; Tracy"
                            2 => "W&#46; Belloso"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pmed.0050203"
                      "Revista" => array:5 [
                        "tituloSerie" => "PLoS Med"
                        "fecha" => "2008"
                        "volumen" => "5"
                        "paginaInicial" => "e203"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18942885"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "What a cardiologist needs to know about patients with human immunodeficiency virus infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46;Y&#46; Hsue"
                            1 => "D&#46;D&#46; Waters"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.105.546465"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2005"
                        "volumen" => "112"
                        "paginaInicial" => "3947"
                        "paginaFinal" => "3957"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16365213"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "HIV-associated dyslipidaemia&#58; pathogenesis and treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Oh"
                            1 => "R&#46;A&#46; Hegele"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1473-3099(07)70287-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet Infect Dis"
                        "fecha" => "2007"
                        "volumen" => "7"
                        "paginaInicial" => "787"
                        "paginaFinal" => "796"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18045561"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cytokines in atherosclerosis&#58; pathogenic and regulatory pathways"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Tedgui"
                            1 => "Z&#46; Mallat"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1152/physrev.00024.2005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Physiol Rev"
                        "fecha" => "2006"
                        "volumen" => "86"
                        "paginaInicial" => "515"
                        "paginaFinal" => "581"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16601268"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High prevalence at computed coronary tomography of non-calcified plaques in asymptomatic HIV patients treated with HAART&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "F&#46; D&#8217;Ascenzo"
                            1 => "E&#46; Cerrato"
                            2 => "A&#46; Calcagno"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.atherosclerosis.2015.03.019"
                      "Revista" => array:6 [
                        "tituloSerie" => "Atherosclerosis"
                        "fecha" => "2015"
                        "volumen" => "240"
                        "paginaInicial" => "197"
                        "paginaFinal" => "204"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25797313"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnosis&#44; prediction&#44; and natural course of HIV-1 protease-inhibitor-associated lipodystrophy&#44; hyperlipidaemia&#44; and diabetes mellitus&#58; a cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46; Carr"
                            1 => "K&#46; Samaras"
                            2 => "A&#46; Thorisdottir"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(98)08468-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1999"
                        "volumen" => "353"
                        "paginaInicial" => "2093"
                        "paginaFinal" => "2099"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10382692"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "HIV lipodystrophy&#58; risk factors&#44; pathogenesis&#44; diagnosis and management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46; Carr"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "AIDS"
                        "fecha" => "2003"
                        "volumen" => "17"
                        "paginaInicial" => "S141"
                        "paginaFinal" => "S148"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12870540"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0213005X12004521"
                          "estado" => "S300"
                          "issn" => "0213005X"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk of premature atherosclerosis and ischemic heart disease associated with HIV infection and antiretroviral therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "L&#46; Calza"
                            1 => "R&#46; Manfredi"
                            2 => "D&#46; Pocaterra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jinf.2008.02.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Infect"
                        "fecha" => "2008"
                        "volumen" => "57"
                        "paginaInicial" => "16"
                        "paginaFinal" => "32"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18358535"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk of myocardial infarction in patients with HIV infection exposed to specific individual antiretroviral drugs from the 3 major drug classes&#58; the data collection on adverse events of anti-HIV drugs &#40;D&#58;A&#58;D&#41; study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46;W&#46; Worm"
                            1 => "C&#46; Sabin"
                            2 => "R&#46; Weber"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/649897"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Infect Dis"
                        "fecha" => "2010"
                        "volumen" => "201"
                        "paginaInicial" => "318"
                        "paginaFinal" => "330"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20039804"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiovascular risks associated with abacavir and tenofovir exposure in HIV-infected persons"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;I&#46; Choi"
                            1 => "E&#46; Vittinghoff"
                            2 => "S&#46;G&#46; Deeks"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/QAD.0b013e328347fa16"
                      "Revista" => array:5 [
                        "tituloSerie" => "AIDS"
                        "fecha" => "2011"
                        "volumen" => "25"
                        "paginaInicial" => "1289"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21516027"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "No risk of myocardial infarction associated with initial antiretroviral treatment containing abacavir&#58; short and long-term results from ACTG A5001&#47;ALLRT"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;H&#46; Ribaudo"
                            1 => "A&#46;B&#46; Constance"
                            2 => "Y&#46; Zheng"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/cid/ciq244"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "2011"
                        "volumen" => "52"
                        "paginaInicial" => "929"
                        "paginaFinal" => "940"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21427402"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk of myocardial infarction and abacavir therapy&#58; no increased risk across 52 GlaxoSmithKline-sponsored clinical trials in adult subjects"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46; Brothers"
                            1 => "J&#46; Hernandez"
                            2 => "A&#46; Cutrell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/QAI.0b013e31819ff0e6"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Acquir Immune Defic Syndr"
                        "fecha" => "2009"
                        "volumen" => "51"
                        "paginaInicial" => "20"
                        "paginaFinal" => "28"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19282778"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is there continued evidence for an association between abacavir usage and myocardial infarction risk in individuals with HIV&#63; A cohort collaboration"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46;A&#46; Sabin"
                            1 => "P&#46; Reiss"
                            2 => "L&#46; Ryom"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s12916-015-0545-7"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Med"
                        "fecha" => "2016"
                        "volumen" => "14"
                        "paginaInicial" => "1"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26728489"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of in-hospital mortality from acute myocardial infarction in HIV sero-positive versus sero-negative individuals"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "D&#46; Pearce"
                            1 => "C&#46; Ani"
                            2 => "Y&#46; Espinosa-Silva"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjcard.2012.05.045"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "2012"
                        "volumen" => "110"
                        "paginaInicial" => "1078"
                        "paginaFinal" => "1084"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22762716"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outcome of percutaneous coronary intervention in HIV-infected patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Segev"
                            1 => "W&#46;J&#46; Cantor"
                            2 => "B&#46;H&#46; Strauss"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/ccd.20774"
                      "Revista" => array:6 [
                        "tituloSerie" => "Catheter Cardiovasc Interv"
                        "fecha" => "2006"
                        "volumen" => "68"
                        "paginaInicial" => "879"
                        "paginaFinal" => "881"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17086530"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiovascular disease in HIV infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "I&#46; Sudano"
                            1 => "L&#46;E&#46; Spieker"
                            2 => "G&#46; Noll"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ahj.2005.07.030"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Heart J"
                        "fecha" => "2006"
                        "volumen" => "151"
                        "paginaInicial" => "1147"
                        "paginaFinal" => "1155"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16781213"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical features of acute coronary syndromes in patients with human immunodeficiency virus infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "P&#46;Y&#46; Hsue"
                            1 => "K&#46; Giri"
                            2 => "S&#46; Erickson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/01.CIR.0000114520.38748.AA"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2004"
                        "volumen" => "109"
                        "paginaInicial" => "316"
                        "paginaFinal" => "319"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14718406"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Markers of inflammation and coagulation indicate a prothrombotic state in HIV-infected patients with long-term use of antiretroviral therapy with or without abacavir"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "E&#46; Jong"
                            1 => "J&#46;C&#46; Meijers"
                            2 => "E&#46;C&#46; Van Gorp"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1742-6405-7-1"
                      "Revista" => array:6 [
                        "tituloSerie" => "AIDS Res Ther"
                        "fecha" => "2010"
                        "volumen" => "7"
                        "paginaInicial" => "1"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20051116"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S147330991170007X"
                          "estado" => "S300"
                          "issn" => "14733099"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Thrombosis and a hypercoagulable state in HIV-infected patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "Y&#46;M&#46;P&#46; Shen"
                            1 => "E&#46;P&#46; Frenkel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Appl Thromb"
                        "fecha" => "2004"
                        "volumen" => "10"
                        "paginaInicial" => "277"
                        "paginaFinal" => "280"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21742049/0000003600000078/v1_201707290050/S2174204917301629/v1_201707290050/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9919"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Case Reports"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003600000078/v1_201707290050/S2174204917301629/v1_201707290050/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917301629?idApp=UINPBA00004E"
]
Article information
ISSN: 21742049
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 9 7 16
2024 October 170 58 228
2024 September 45 28 73
2024 August 150 40 190
2024 July 36 35 71
2024 June 44 33 77
2024 May 36 24 60
2024 April 45 41 86
2024 March 51 24 75
2024 February 27 21 48
2024 January 39 40 79
2023 December 27 27 54
2023 November 48 27 75
2023 October 49 14 63
2023 September 40 27 67
2023 August 66 20 86
2023 July 65 10 75
2023 June 37 12 49
2023 May 46 39 85
2023 April 37 17 54
2023 March 63 26 89
2023 February 65 20 85
2023 January 28 9 37
2022 December 48 35 83
2022 November 66 32 98
2022 October 36 38 74
2022 September 36 37 73
2022 August 47 31 78
2022 July 45 33 78
2022 June 48 29 77
2022 May 41 32 73
2022 April 42 31 73
2022 March 36 51 87
2022 February 31 40 71
2022 January 33 34 67
2021 December 38 35 73
2021 November 45 40 85
2021 October 47 53 100
2021 September 22 29 51
2021 August 35 41 76
2021 July 22 19 41
2021 June 31 36 67
2021 May 40 46 86
2021 April 77 73 150
2021 March 62 25 87
2021 February 55 22 77
2021 January 33 21 54
2020 December 35 9 44
2020 November 50 21 71
2020 October 22 16 38
2020 September 38 9 47
2020 August 30 11 41
2020 July 54 9 63
2020 June 33 11 44
2020 May 45 13 58
2020 April 47 18 65
2020 March 38 10 48
2020 February 119 23 142
2020 January 34 7 41
2019 December 39 11 50
2019 November 63 7 70
2019 October 43 6 49
2019 September 32 8 40
2019 August 37 8 45
2019 July 36 10 46
2019 June 32 14 46
2019 May 47 9 56
2019 April 28 13 41
2019 March 96 10 106
2019 February 89 9 98
2019 January 70 8 78
2018 December 106 21 127
2018 November 225 8 233
2018 October 526 21 547
2018 September 153 18 171
2018 August 56 7 63
2018 July 43 18 61
2018 June 46 15 61
2018 May 53 5 58
2018 April 43 5 48
2018 March 80 10 90
2018 February 26 10 36
2018 January 28 1 29
2017 December 72 7 79
2017 November 66 7 73
2017 October 60 15 75
2017 September 74 45 119
2017 August 116 62 178
2017 July 49 59 108
Show all

Follow this link to access the full text of the article

Idiomas
Revista Portuguesa de Cardiologia (English edition)
en pt

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

By checking that you are a health professional, you are stating that you are aware and accept that the Portuguese Journal of Cardiology (RPC) is the Data Controller that processes the personal information of users of its website, with its registered office at Campo Grande, n.º 28, 13.º, 1700-093 Lisbon, telephone 217 970 685 and 217 817 630, fax 217 931 095, and email revista@spc.pt. I declare for all purposes that the information provided herein is accurate and correct.