title: Global cardiovascular risk in patients with HIV infection: concordance and differences in estimates according to three risk equations (Framingham, SCORE, and PROCAM).
abstract: To compare cardiovascular risk stratification according to Framingham, PROCAM (Prospective Cardiovascular Münster), and SCORE (Systematic Coronary Risk Evaluation) equations in patients with HIV infection, a cross-sectional study of a well-characterized cohort of 760 HIV-infected adults managed at the outpatient Infectious Disease Unit in 2003 was conducted. Cardiovascular risk score was examined and patients were classified as having low, moderate, or high risk using Framingham and PROCAM (<10%, 10%-20%, and <20%, respectively) and SCORE (<3%, 3%-4%, and >/=5%, respectively) equations. The prevalence of patients with low, moderate and high cardiovascular risk was 76.6%, 15.1%, and 8.3% by the Framingham, respectively, 90.1%, 4.9%, and 5% by the PROCAM, respectively, and 88.6%, 3%, and 8.4% by SCORE, respectively. Concordance between these three risk functions was significant, but globally moderate (Framingham and PROCAM, kappa 0.36, p < 0.0001; Framingham and SCORE, kappa 0.32, p < 0.0001; PROCAM and SCORE, kappa 0.46, p < 0.0001). The Framingham equation categorized a higher proportion of HIV-infected male patients with moderate cardiovascular risk and a lower proportion of those with low risk (p < 0.0001) compared with PROCAM and SCORE. The present study showed a high prevalence of HIV-infected patients at low cardiovascular risk regardless of the assessed coronary risk system used. However, compared with PROCAM and SCORE, Framingham risk equation in HIV-infected patients identified a higher number of male patients with moderate cardiovascular risk.
authors.affiliation: Internal Medicine and Infectious Disease Department, Hospital del Mar, Barcelona, Spain.
authors.forename: Hernando
authors.initials: H
authors.lastname: Knobel
authors.forename: Carlos
authors.initials: C
authors.lastname: Jericó
authors.forename: Milagro
authors.initials: M
authors.lastname: Montero
authors.forename: María L
authors.initials: ML
authors.lastname: Sorli
authors.forename: Manuela
authors.initials: M
authors.lastname: Velat
authors.forename: Ana
authors.initials: A
authors.lastname: Guelar
authors.forename: Pere
authors.initials: P
authors.lastname: Saballs
authors.forename: Juan
authors.initials: J
authors.lastname: Pedro-Botet
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000821:virology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008297:Male; D018570:Risk Assessment; D012307:Risk Factors