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ObjectiveThe clinical profile and surgical outcomes of patients with constrictive pericarditis were compared in HIV-positive and -negative individuals.MethodsThis study was a retrospective analysis of patients diagnosed with constrictive pericarditis at Inkosi Albert Luthuli Central Hospital, Durban, over a 10-year period (2004-2014).ResultsOf 83 patients with constrictive pericarditis, 32 (38.1%) were HIV positive. Except for pericardial calcification, which was more common in HIV-negative subjects (n = 15, 29.4% vs n = 2, 6.3%; p = 0.011), the clinical profile was similar in the two groups. Fourteen patients died preoperatively (16.9%) and three died peri-operatively (5.8%). On multivariable analysis, age (OR 1.17; 95% CI: 1.03-1.34; p = 0.02), serum albumin level (OR 0.63; 95% CI: 0.43-0.92; p = 0.016), gamma glutamyl transferase level (OR 0.97; 95% CI: 0.94-0.1.0; p = 0.034) and pulmonary artery pressure (OR 1.49; 95% CI: 1.07-2.08; p = 0.018) emerged as independent predictors of pre-operative mortality rate. Peri-operative complications occurred more frequently in HIV-positive patients [9 (45%) vs 6 (17.6%); p = 0.030].ConclusionsWithout surgery, tuberculous constrictive pericarditis was associated with a high mortality rate. Although peri-operative complications occurred more frequently, surgery was not associated with increased mortality rates in HIV-positive subjects.

Original publication

DOI

10.5830/cvja-2019-015

Type

Journal

Cardiovascular journal of Africa

Publication Date

09/2019

Volume

30

Pages

251 - 257

Addresses

Department of Cardiology, University of KwaZulu-Natal, Durban, South Africa. Email: naidood@ukzn.ac.za.

Keywords

Humans, Pericarditis, Tuberculous, HIV Infections, Pericarditis, Constrictive, Antitubercular Agents, Anti-HIV Agents, Treatment Outcome, Pericardiectomy, Hospital Mortality, Risk Assessment, Risk Factors, Retrospective Studies, Time Factors, Adult, Aged, Middle Aged, South Africa, Female, Male, Young Adult, Coinfection