Cardiovascular risk assessment: a comparison of the Framingham, PROCAM, and DAD equations in HIV-infected persons.
This study aims to estimate the risk of cardiovascular disease (CVD) and to assess the agreement between the Framingham, Framingham with aggravating factors, PROCAM, and DAD equations in HIV-infected patients. A cross-sectional study was conducted in an outpatient centre in Brazil. 294 patients older than 19 years were enrolled. Estimates of 10-year cardiovascular risk were calculated. The agreement between the CVD risk equations was assessed using Cohen's kappa coefficient. The participants' mean age was 36.8 years (SD = 10.3), 76.9% were men, and 66.3% were on antiretroviral therapy. 47.8% of the participants had abdominal obesity, 23.1% were current smokers, 20.0% had hypertension, and 2.0% had diabetes. At least one lipid abnormality was detected in 72.8%, and a low HDL-C level was the most common. The majority were classified as having low risk for CV events. The percentage of patients at high risk ranged from 0.4 to 5.7. The PROCAM score placed the lowest proportion of the patients into a high-risk group, and the Framingham equation with aggravating factors placed the highest proportion of patients into the high-risk group. Data concerning the comparability of different tools are informative for estimating the risk of CVD, but accuracy of the outcome predictions should also be considered.
Postgraduate Studies Program, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Brazil ; Department of Medicine, Catholic University of Goiás, Brazil.
Max Weyler
MW
Nery
Celina Maria Turchi
CM
Martelli
Erika Aparecida
EA
Silveira
Clarissa Alencar
CA
de Sousa
Marianne de Oliveira
Mde O
Falco
Aline de Cássia Oliveira
Ade C
de Castro
Jorge Tannus
JT
Esper
Luis Carlos Silva e
LC
Souza
Marília Dalva
MD
Turchi
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D002318:Cardiovascular Diseases / Q000150:complications* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors