title: Framingham risk score and early markers of atherosclerosis in a cohort of adults infected with HIV.
abstract: BACKGROUND
  The utility of the Framingham risk score among individuals infected with HIV is poorly understood. We examined the association of Framingham risk scores with surrogate markers of atherosclerosis in a carefully characterized cohort of adults infected with HIV.
  
  
  METHODS
  We calculated Framingham risk scores and measured carotid intima-media thickness (c-IMT) and coronary artery calcium (CAC) scores in 334 participants from the Nutrition for Healthy Living study. Cardiovascular risk factors, c-IMT and CAC scores were assessed for each Framingham risk subgroup (low versus intermediate/high risk). We used adjusted and unadjusted linear and logistic regression to examine the association between clinical factors and Framingham risk group with c-IMT and CAC scores.
  
  
  RESULTS
  Patients with intermediate/high Framingham risk scores were more likely to have internal c-IMT ≥ 1.0 mm (26% versus 12%; P=0.003) and common c-IMT ≥ 0.8 mm (22% versus 5%; P < 0.001). These patients were also more likely to have detectable CAC (78% versus 48%; P < 0.001). Intermediate/high Framingham risk scores were significantly associated with internal c-IMT ≥ 1.0 mm (odds ratio 2.65 [95% confidence interval 1.37-5.13]) and common c-IMT ≥ 0.8 mm (odds ratio 5.24 [95% confidence interval 2.39-11.50]). Intermediate/high Framingham risk scores were also significantly associated with detectable CAC (odds ratio 3.84 [95% confidence interval 2.05-7.16]). The addition of HIV-related variables did not improve the accuracy of the Framingham risk score.
  
  
  CONCLUSIONS
  Our study shows that increased Framingham risk scores are associated with abnormal early and late surrogate markers of atherosclerosis in adults infected with HIV, and might predict the risk of cardiovascular complications in this population.
authors.affiliation: Department of Medicine, Tufts Medical Center, Boston, MA, USA. efalcone@tuftsmedicalcenter.org
authors.forename: E Liana
authors.initials: EL
authors.lastname: Falcone
authors.forename: Alexandra
authors.initials: A
authors.lastname: Mangili
authors.forename: Sally
authors.initials: S
authors.lastname: Skinner
authors.forename: Ahsan
authors.initials: A
authors.lastname: Alam
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Polak
authors.forename: Christine A
authors.initials: CA
authors.lastname: Wanke
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000150:complications / Q000453:epidemiology / Q000378:metabolism; D015415:Biomarkers / Q000032:analysis*; D002118:Calcium / Q000032:analysis*; D002339:Carotid Arteries / Q000473:pathology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000821:virology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012107:Research Design; D018570:Risk Assessment; D012307:Risk Factors; D017539:Tunica Intima / Q000378:metabolism / Q000473:pathology*; D017540:Tunica Media / Q000378:metabolism / Q000473:pathology*
chemical_list: D015415:Biomarkers; D002118:Calcium