Comparison of the ACC/AHA and Framingham algorithms to assess cardiovascular risk in HIV-infected patients

Neto, Lauro Ferreira da Silva Pinto; Dias, Fernanda Rezende; Bressan, F.; Santos, Carolina Rocio Oliveira

doi:10.1016/j.bjid.2017.06.007

Cited by 13 publications

(6 citation statements)

References 19 publications

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“…On the other hand the studies that used kappa statistic, the range of values was 0.22 (fair agreement)–0.78 (substantial agreement). In the HIV-infected populations, two studies 40 , 41 used kappa to test agreement between FRS and ASCVD algorithms with values of 0.61 and 0.75 falling in the substantial agreement category. The other study 42 used prevalence bias adjusted kappa (PABAK) and found no statistical difference in risk scores between tools.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Predicted Cardiovascular Risk Profiles by Different CVD Risk-Scoring Algorithms between HIV-1-Infected and Uninfected Adults: A Cross-Sectional Study in Tanzania

Msoka¹,

Rogath²,

Guilder³

et al. 2021

HIV

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Purpose Cardiovascular disease (CVD) risk assessment is a suitable way to differentiate between high-risk individuals requiring intervention and risk modification, and those at low risk. However, concerns have been raised when adopting a CVD-risk prediction algorithm for HIV-infected patients in sub-Saharan Africa. Patients and Methods We compared cardiovascular risk profiles between HIV-infected (with and without antiretroviral therapy (ART)) and HIV-uninfected adults as predicted by the American College of Cardiology/American Heart Association (ASCVD) and the Framingham cardiovascular risk score (FRS) algorithms and assessed the concordance of the algorithms in predicting 10-year CVD risk separately in HIV-infected and uninfected groups in a hospital-based cross-sectional study in Tanzania. A cross-sectional hospital-based study including 40 HIV-infected ART-naive, 64 HIV-infected on ART, and 50 HIV-uninfected adults was conducted. Traditional cardiovascular risk factors were determined by standard investigations. The primary outcome was the absolute 10-year CVD risk score based on the two algorithms. Results Compared to HIV-uninfected, HIV-infected adults were classified at a higher 10-year CVD risk. ASCVD algorithms predicted a higher proportion of high-risk individuals compared to FRS in both HIV-infected and uninfected groups. The concordance between ASCVD and FRS-lipid algorithms was reasonable for both HIV-infected and uninfected groups though relatively higher in the HIV-uninfected group. Conclusion HIV-infected individuals have a higher 10-year cardiovascular risk compared to HIV-uninfected persons. The concordance between ASCVD and FRS-lipid algorithms is reasonable in both HIV-uninfected and infected persons in Tanzania. Development of an HIV-specific algorithm is needed to accurately predict CVD risk in this population at high-risk.

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Section: Discussionmentioning

confidence: 99%

Comparison of Predicted Cardiovascular Risk Profiles by Different CVD Risk-Scoring Algorithms between HIV-1-Infected and Uninfected Adults: A Cross-Sectional Study in Tanzania

Msoka¹,

Rogath²,

Guilder³

et al. 2021

HIV

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“…They highlight that the models with best performance in Latin America are Framingham and ASCVD. Some studies with HIV populations have been reported from Brazil, although with small sample size and short follow-up [24][25][26][27] .…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Risk Prediction Models in People Living with HIV in Colombia

García-Peña¹,

Vries²,

Aldana-Bitar³

et al. 2022

RIC

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Background: People living with HIV are at increased risk of cardiovascular disease. Cardiovascular risk (CVR) prediction scores are powerful tools for individualized assessment that inform decision-making about follow-up frequency, hypolipemiant treatment intensification, and choice antiretroviral therapy. Objectives: The objectives of the study were to evaluate the performance of multiple cardiovascular assessment scores in predicting major adverse cardiovascular events (MACE) at 5 and 10 years. Framingham (2004, 2008, and Colombia-adjusted), SCORE, PROCAM, ASCVD, and D:A:D scores were included in the analysis. Methods: Data were obtained from a medical registry of adults living with HIV attended by a teaching hospital in Colombia. All patients with complete information necessary for risk score calculations and determination of MACE at 5 and 10 years were included in the study. Receiver operating characteristic curves (ROC) were generated using calculations with all the aforementioned models for every individual. Differences between curves were compared with De-Long's test. Results: A total of 808 patients were included in the analysis. Mean age was 35 years, and 12% were female.The majority of subjects had low and very low CVR. Eight MACE occurred during follow-up. Area under ROC curves were: Framingham (0.90), Framingham ATP3 (0.92), Framingham calibrated for Colombia (0.90), SCORE (0.92), PROCAM (0.92), ASCVD (0.89), and D:A:D (0.92), with no statistically significant differences. Conclusions: The evaluated scores had an acceptable performance for HIV-infected patients in the studied cohort, especially for those in low and very low risk categories. (REV INVEST CLIN. [AHEAD OF PRINT]

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“…Since earlier studies suggested that the existing cardiovascular disease risk scores may inaccurately estimate the risk of clinical events in HIV population, more recent publications have attempted to confirm and extend this work [103, 104, 105•, 106–112]. There remains conflicting data about how well Framingham and other non-HIV-specific algorithms predict cardiovascular disease risk with some studies showing good discrimination or calibration [104, 106] and others, less so [105•, 106, 107, 109, 110].…”

Section: Cvd Risk Assessment and Novel Cvd Risk Factors In Hivmentioning

confidence: 92%

HIV and Cardiovascular Disease: Update on Clinical Events, Special Populations, and Novel Biomarkers

So‐Armah

Freiberg

2018

Curr HIV/AIDS Rep

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Heart failure, peripheral artery disease, and stroke are CVD modalities deserving more attention in the context of HIV infection in the highly active antiretroviral therapy era. Incidence data on clinical CVD from HIV populations in low- and middle-income countries are limited. Multisubstance use is common in HIV, but understudied as a moderator or mediator of the association between HIV and CVD. CVD risk assessment in HIV remains challenging, but new research into novel biomarkers may provide further insights. There is also a need for inclusion of non-biologic factors in our attempts to understand, quantify, and predict CVD risk among PLWHA. Significant attention has been paid to generating and testing hypotheses to understand the mechanisms of myocardial infarction in HIV. Similar attention is deserving for heart failure, PAD, stroke, and cardiovascular disease risk in resource-limited settings and among substance users with HIV.

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Comparison of the ACC/AHA and Framingham algorithms to assess cardiovascular risk in HIV-infected patients

Cited by 13 publications

References 19 publications

Comparison of Predicted Cardiovascular Risk Profiles by Different CVD Risk-Scoring Algorithms between HIV-1-Infected and Uninfected Adults: A Cross-Sectional Study in Tanzania

Comparison of Predicted Cardiovascular Risk Profiles by Different CVD Risk-Scoring Algorithms between HIV-1-Infected and Uninfected Adults: A Cross-Sectional Study in Tanzania

Cardiovascular Risk Prediction Models in People Living with HIV in Colombia

HIV and Cardiovascular Disease: Update on Clinical Events, Special Populations, and Novel Biomarkers

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