Prevalence and concordance of high cardiovascular disease scores in HIV/AIDS patients from Croatia and Serbia with four international algorithms.
BACKGROUND
We evaluated cardiovascular risks in HIV-infected patients from Croatia and Serbia and the eligibility for statin therapy as recommended by the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines, European AIDS Clinical Society (EACS) Guidelines and European Society of Cardiology and the European Atherosclerosis Society (ESC/EAS) guidelines for cardiovascular disease (CVD) prevention [1-3].


METHODS
A cross-sectional analysis of consecutive patients between 40 and 79 years old who had received antiretroviral therapy for at least 12 months was performed.


RESULTS
Of 254 (132 from Croatia and 122 from Serbia) persons included in the study, 76% were male; median age was 49 years. Up to 51.6% of persons had a high CVD risk. The prevalence of current smoking was 42.9%, hypertension 31.5% and hypercholesterolaemia (>6.2 mmol/L) 35.4%. Statins would be recommended to 21.3% (95% CI, 16.3% to 27.4%) of persons by the EACS, 25.6% (95% CI, 20.2% to 31.9%) by ESC/EAS and 37.9% (95% CI, 31.6 to 44.6%) by the ACC/AHA guidelines. A high 5-year data collection on adverse effects of anti-HIV drugs study risk score (>5%) had a moderate agreement with the high (≥20%) 10-year CVD Framingham risk score (kappa=0.47) and high (≥5%) 10-year European systematic coronary risk evaluation score algorithm (kappa=0.47), and substantial agreement with the elevated (≥7.5%) 10-year Pooled Cohort Atherosclerotic CVD risk equation score (kappa=0.63).


CONCLUSIONS
We found a high prevalence of CVD risks in patients from Croatia and Serbia. The ACC/AHA guideline would recommend statins more often than ESC/EAS and EACS guidelines.
Department of Infectious Diseases, University Hospital for Infectious Diseases, Zagreb, Croatia.
Josip
J
Begovac
Department of Pharmacology and Clinical Pharmacology, School of Medicine, University of Belgrade, Belgrade, Serbia and Montenegro.
Gordana
G
Dragovic
Department of Infectious Diseases, University Hospital for Infectious Diseases, Zagreb, Croatia.
Klaudija
K
Viskovic
HIV/AIDS Unit, Institute for Infectious and Tropical Diseases, Belgrade, Serbia and Montenegro.
Jovana
J
Kusic
Department of Infectious Diseases, University Hospital for Infectious Diseases, Zagreb, Croatia.
Marta Perovic
MP
Mihanovic
Department of Infectious Diseases, University Hospital for Infectious Diseases, Zagreb, Croatia.
Davorka
D
Lukas
HIV/AIDS Unit, Institute for Infectious and Tropical Diseases, Belgrade, Serbia and Montenegro.
Djordje
D
Jevtovic