title: Identifying HIV patients with an unfavorable cardiovascular risk profile in the clinical practice: results from the SIMONE study.
abstract: OBJECTIVE
  To identify and characterize HIV-infected patients at higher cardiovascular risk in ordinary clinical settings.
  
  
  METHODS
  Multicenter, nationwide cross-sectional study.
  
  
  METHODS
  Consecutive HIV-patients, attending scheduled visits at facilities involved in the Italian coordination group for the study of allergies and HIV infection (CISAI), were included between February and April, 2005. Their 10-year probability of acute coronary events was calculated using the Framingham Risk Score (FRS) as well as 3 other cardiovascular algorithms ("PROCAM", "PROGETTO CUORE", "SCORE"); Metabolic Syndrome (MS) was diagnosed according to the National Cholesterol Education Program definitions. An estimated 10-year CVD >or=10% and/or MS led to the diagnosis of high CV risk. We compared selected clinical features between high- and low-risk patients.
  
  
  RESULTS
  A total of 1230 HIV infected patients (72% males, mean age of 43+/-9 years), 185 of whom treatment-naive, were evaluated. FRS gave the highest estimate of CV risk. The mean 10-year risk for acute coronary events according to FRS was 7.4+/-7.0. MS was present in 22% of the observed patients. Accordingly, 443 patients (36%) were classified at high risk. Twelve percent of the patients (n=142) had both a FRS >or=10% and a diagnosis of MS. The main single predictor of increased cardiovascular risk was smoking (60% of whole sample). A higher prevalence of clinically evident lipodystrophy and a higher CD4 T-cell counts were found both in patients with higher FRS and in patients with high FRS and MS (both p<0.001).
  
  
  CONCLUSIONS
  The worst estimation of CV risk was obtained with the FRS algorithm. Clinical evidence of lipodystrophy and higher CD4 T-cell counts were closely associated to a worse cardiovascular risk profile.
authors.affiliation: Department of Infectious Diseases, Santa Maria Hospital, Perugia, Italy. giuseppedesocio@yahoo.it
authors.forename: Giuseppe Vittorio L
authors.initials: GV
authors.lastname: De Socio
authors.forename: Giustino
authors.initials: G
authors.lastname: Parruti
authors.forename: Tiziana
authors.initials: T
authors.lastname: Quirino
authors.forename: Elena
authors.initials: E
authors.lastname: Ricci
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Schillaci
authors.forename: Beatrice
authors.initials: B
authors.lastname: Adriani
authors.forename: Patrizia
authors.initials: P
authors.lastname: Marconi
authors.forename: Marzia
authors.initials: M
authors.lastname: Franzetti
authors.forename: Canio
authors.initials: C
authors.lastname: Martinelli
authors.forename: Francesca
authors.initials: F
authors.lastname: Vichi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Penco
authors.forename: Claudio
authors.initials: C
authors.lastname: Sfara
authors.forename: Giordano
authors.initials: G
authors.lastname: Madeddu
authors.forename: Paolo
authors.initials: P
authors.lastname: Bonfanti
mesh_terms: D000328:Adult; D000465:Algorithms; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000821:virology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D015497:HIV-1; D039682:HIV-Associated Lipodystrophy Syndrome / Q000453:epidemiology / Q000821:virology; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology