{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T10:54:44Z","timestamp":1762080884098,"version":"build-2065373602"},"reference-count":31,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,12,13]],"date-time":"2022-12-13T00:00:00Z","timestamp":1670889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>People living with human immunodeficiency virus have an increased cardiovascular risk due to higher prevalence of traditional risk factors, such as smoking, dyslipidemia, hypertension, diabetes, or obesity, and particular risk factors, such as inflammation, endothelial dysfunction, and antiretroviral therapy. Thus, people living with human immunodeficiency virus can develop accelerated atherosclerosis. The incidence of coronary artery disease in these patients may be twice as high compared with that of HIV-negative individuals with similar characteristics. \u201cPorcelain aorta\u201d is a term used to describe extensive circumferential calcification of the thoracic aorta. The pathophysiology of porcelain aorta is not fully understood. We present a case of a young man who was a smoker and living with HIV since childhood, without other traditional cardiovascular risk factors, who presented to the emergency room with a positive stress test for myocardial ischemia. Transthoracic echocardiography revealed normal regional and global myocardial wall motion, ascending aorta ectasia, and moderate aortic regurgitation. Coronary angiography showed a critical calcified proximal left anterior descending artery stenosis and an important calcification of the thoracic aorta. Therefore, the most important challenge was the management of coronary syndrome in a young person living with HIV, with associated porcelain aorta and aortic regurgitation.<\/jats:p>","DOI":"10.3390\/diagnostics12123147","type":"journal-article","created":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T02:22:41Z","timestamp":1670984561000},"page":"3147","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Porcelain Aorta in a Young Person Living with HIV Who Presented with Angina"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9320-9820","authenticated-orcid":false,"given":"Mircea","family":"Bajdechi","sequence":"first","affiliation":[{"name":"Doctoral School of Medicine, \u201cOvidius\u201d University of Constanta, 900470 Constanta, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandru","family":"Scafa-Udriste","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u201cCarol Davila\u201d of Bucharest, 050474 Bucuresti, Romania"},{"name":"Emergency Clinical Hospital of Bucharest, 014461 Bucuresti, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vlad","family":"Ploscaru","sequence":"additional","affiliation":[{"name":"Emergency Clinical Hospital of Bucharest, 014461 Bucuresti, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucian","family":"Calmac","sequence":"additional","affiliation":[{"name":"Emergency Clinical Hospital of Bucharest, 014461 Bucuresti, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teodor","family":"Bajeu","sequence":"additional","affiliation":[{"name":"Emergency Clinical Hospital of Bucharest, 014461 Bucuresti, Romania"},{"name":"Doctoral School, Politehnica University of Bucharest-Applied Chemistry and Materials Science, 060042 Bucuresti, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana","family":"Gurghean","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u201cCarol Davila\u201d of Bucharest, 050474 Bucuresti, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sorin","family":"Rugina","sequence":"additional","affiliation":[{"name":"Doctoral School of Medicine, \u201cOvidius\u201d University of Constanta, 900470 Constanta, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.jacc.2012.06.063","article-title":"HIV and coronary heart disease: Time for a better understanding","volume":"61","author":"Boccara","year":"2013","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Bavinger, C., Bendavid, E., Niehaus, K., Olshen, R.A., Olkin, I., Sundaram, V., Wein, N., Holodniy, M., Hou, N., and Owens, D.K. (2013). Risk of Cardiovascular Disease from Antiretroviral Therapy for HIV: A Systematic Review. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0059551"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2506","DOI":"10.1210\/jc.2006-2190","article-title":"Increased acute myocardial infarction rates and cardiovascular risk factors among patients with human immunodeficiency virus disease","volume":"92","author":"Triant","year":"2007","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1016\/S1473-3099(15)00056-0","article-title":"Future challenges for clinical care of an ageing population infected with HIV: A modelling study","volume":"15","author":"Smit","year":"2015","journal-title":"Lancet Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1161\/CIRCULATIONAHA.114.011867","article-title":"Porcelain aorta: A comprehensive review","volume":"131","author":"Abramowitz","year":"2015","journal-title":"Circulation"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1016\/S0003-4975(98)01370-8","article-title":"Management of porcelain aorta during coronary artery bypass grafting","volume":"67","author":"Leyh","year":"1999","journal-title":"Ann. Thorac. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1067\/mtc.2000.110191","article-title":"The atherosclerotic aorta at aortic valve replacement: Surgical strategies and results","volume":"120","author":"Gillinov","year":"2000","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/S0022-5223(19)34984-0","article-title":"Management of the severely atherosclerotic ascending aorta during cardiac operations","volume":"103","author":"Wareing","year":"1992","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e000703","DOI":"10.1136\/openhrt-2017-000703","article-title":"\u201cPorcelain aorta\u201d: A proposed definition and classification of ascending aortic calcification","volume":"5","author":"Snow","year":"2018","journal-title":"Open Heart"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.ijcard.2011.02.026","article-title":"Prevalence of comorbidities and associated cardiac diseases in patients with valve aortic stenosis. Potential implications for the decision-making process","volume":"159","author":"Faggiano","year":"2012","journal-title":"Int. J. Cardiol."},{"key":"ref_11","unstructured":"Anan, A., Rmilah, A., and Srikanth Yandrapalli, F.B.B. (2022). Porcelain Aorta. Treasure Isl, StatPearls Publ."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.semarthrit.2012.11.001","article-title":"Aortic and coronary calcifications in Takayasu arteritis","volume":"43","author":"Seyahi","year":"2013","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/S0140-6736(14)60604-8","article-title":"Trends in underlying causes of death in people with HIV from 1999 to 2011 (D:A:D): A multicohort collaboration","volume":"384","author":"Smith","year":"2014","journal-title":"Lancet"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1001\/jamacardio.2017.0264","article-title":"Association between HIV infection and the risk of heart failure with reduced ejection fraction and preserved ejection fraction in the antiretroviral therapy era: Results from the veterans aging cohort study","volume":"2","author":"Freiberg","year":"2017","journal-title":"JAMA Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1086\/652283","article-title":"Causes of death in HIV-1-Infected patients treated with antiretroviral therapy, 1996-2006: Collaborative analysis of 13 HIV cohort studies","volume":"50","author":"May","year":"2010","journal-title":"Clin. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1007\/s11904-013-0168-6","article-title":"Cardiovascular disease and HIV infection","volume":"10","author":"Triant","year":"2013","journal-title":"Curr. HIV\/AIDS Rep."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/j.atherosclerosis.2017.05.004","article-title":"Cardiovascular risk in advanced na\u00efve HIV-infected patients starting antiretroviral therapy: Comparison of three different regimens - PREVALEAT II cohort","volume":"263","author":"Maggi","year":"2017","journal-title":"Atherosclerosis"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1097\/QAI.0b013e31821d33a5","article-title":"Association between HIV infection, antiretroviral therapy, and risk of acute myocardial infarction: A cohort and nested case-control study using Qu\u00e9bec\u2019s Public Health Insurance database","volume":"57","author":"Durand","year":"2011","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1086\/649897","article-title":"Risk of Myocardial Infarction in Patients with HIV Infection Exposed to Specific Individual Antiretroviral Drugs from the 3 Major Drug Classes: The Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) Study","volume":"201","author":"Worm","year":"2010","journal-title":"J. Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1111\/j.1468-1293.2009.00751.x","article-title":"Abacavir and risk of myocardial infarction in HIV-infected patients on highly active antiretroviral therapy: A population-based nationwide cohort study","volume":"11","author":"Obel","year":"2010","journal-title":"HIV Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1093\/infdis\/jiy001","article-title":"Abacavir induces arterial thrombosis in a murine model","volume":"218","author":"Andujar","year":"2018","journal-title":"J. Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1093\/cid\/cir269","article-title":"Abacavir use and risk of acute myocardial infarction and cerebrovascular events in the highly active antiretroviral therapy era","volume":"53","author":"Bedimo","year":"2011","journal-title":"Clin. Infect. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"F1","DOI":"10.1097\/QAD.0b013e32833562c5","article-title":"Abacavir-based therapy does not affect biological mechanisms associated with cardiovascular dysfunction","volume":"24","author":"Larrousse","year":"2010","journal-title":"AIDS"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1111\/hiv.12878","article-title":"2019 update of the European AIDS Clinical Society Guidelines for treatment of people living with HIV version 10.0","volume":"10","author":"Ryom","year":"2020","journal-title":"HIV Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e017578","DOI":"10.1161\/JAHA.119.017578","article-title":"Hiv infection and long-term residual cardiovascular risk after acute coronary syndrome","volume":"9","author":"Boccara","year":"2020","journal-title":"J. Am. Heart Assoc."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1161\/CIRCULATIONAHA.117.033369","article-title":"Global Burden of Atherosclerotic Cardiovascular Disease in People Living with HIV","volume":"138","author":"Shah","year":"2018","journal-title":"Circulation"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1038\/s41569-019-0219-9","article-title":"HIV infection and coronary heart disease: Mechanisms and management","volume":"16","author":"Hsue","year":"2019","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Bajdechi, M., Mihai, C., Scafa-Udriste, A., Cherry, A., Zamfir, D., Dumitru, I., Cernat, R., and Rugina, S. (2021). Severe coronary artery disease in a person living with hiv. Medicina, 57.","DOI":"10.3390\/medicina57060595"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Poznyak, A.V., Bezsonov, E.E., Borisov, E.E., Grechko, A.V., Kartuesov, A.G., and Orekhov, A.N. (2022). Atherosclerosis in HIV Patients: What Do We Know so Far?. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23052504"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fcvm.2018.00185","article-title":"HIV Proteins and Endothelial Dysfunction: Implications in Cardiovascular Disease","volume":"5","author":"Anand","year":"2018","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1161\/CIRCULATIONAHA.107.712141","article-title":"Calcification of the thoracic aorta as detected by spiral computed tomography among stable angina pectoris patients: Association with cardiovascular events and death","volume":"118","author":"Eisen","year":"2008","journal-title":"Circulation"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/12\/3147\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:40:35Z","timestamp":1760146835000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/12\/3147"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,13]]},"references-count":31,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["diagnostics12123147"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics12123147","relation":{},"ISSN":["2075-4418"],"issn-type":[{"type":"electronic","value":"2075-4418"}],"subject":[],"published":{"date-parts":[[2022,12,13]]}}}