The Framingham function overestimates the risk of ischemic heart disease in HIV-infected patients from Barcelona

Herrera, Sabina; Guelar, Ana; Sorlí, Luisa; Vila, Joan; Molas, Ema; Grau, María; Marrugat, Jaume; Esteve, Erika; Güerri‐Fernández, Robert; Montero, Milagro; Knobel, Hernando

doi:10.1080/15284336.2016.1177266

Cited by 13 publications

(19 citation statements)

References 23 publications

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“…In contrast, studies which have actually investigated the predictive performance of different algorithms have shown conflicting results 15,[17][18][19][20][21][22][23] . However, these studies were limited by the use of cross-sectional measurements of subclinical CVD endpoints (for which the algorithms were not designed) [24][25][26][27][28] , relatively small sample sizes resulting in a limited number of observed CVD events 17,21,23,25,[27][28][29] , a limited selection of algorithms for comparison [17][18][19][20][21]23,25,29 , and/or by not providing external validation 19,20 .…”

Section: Introductionmentioning

confidence: 99%

Predictive Performance of Cardiovascular Disease Risk Prediction Algorithms in People Living With HIV

Zoest

Law

Sabin

et al. 2019

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Sharp & Dohme, Bristol-Myers Squibb, Janssen-Cilag, ViiV HealthCare, and consultancy and presentation fees from Gilead Sciences. Prof. C.A. Sabin has received funding for participation in Advisory Boards, for membership of Data Safety and Monitoring Committees, and for the preparation of educational materials from Gilead Sciences, ViiV Healthcare and Janssen-Cilag. Dr. I. Vaartjes has nothing to disclose.

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Section: Introductionmentioning

confidence: 99%

Predictive Performance of Cardiovascular Disease Risk Prediction Algorithms in People Living With HIV

Zoest

Law

Sabin

et al. 2019

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…An update from D:A:D: study concluded that Framingham model performed well compared to DAD equation for global CVD risk [6]. In contrast a study from Spain showed that Framingham risk equation significantly overestimated ischemic heart events in South-European HIV-infected patients [7]. We assessed the agreement between predicted global CVD risk according to the Framingham equation [4] and observed CVD morbidity in a consecutive series of HIV-positive subjects who were followed up until 10 years.…”

Section: Introductionmentioning

confidence: 99%

Observed versus predicted cardiovascular events and all-cause death in HIV infection: a longitudinal cohort study

et al. 2017

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BackgroundThe aim of the study was to assess the applicability of an algorithm predicting 10-year cardiovascular disease (CVD) generated in the setting of the Framingham Heart Study to a real-life, contemporary Italian cohort of HIV-positive subjects.MethodsThe study was an observational longitudinal cohort study. The probability for 10-year CVD events according to the Framingham algorithm was assessed in 369 consecutive HIV-positive participants free from overt CVD enrolled in 2004, who were followed for a median of 10.0 years (interquartile range, 9.1-10.1). Cardiovascular events included myocardial infarction, hospitalized heart failure, revascularized angina, sudden cardiac death, stroke, peripheral arterial disease.ResultsOver 3097 person-years of observation, we observed a total of 34 CVD events, whereas Framingham algorithm predicted the occurrence of 34.3 CVD events. CVD event rate was 11.0/1000 person-years of follow-up. In a receiver operating characteristics curve analysis, Framingham risk equation showed an excellent predictive value for incident CVD events (c-statistics, 0.83; 95% confidence interval, 0.76-0.90). In a multivariable Cox analysis, age, smoking and diabetes were independent predictors of CVD events. All-cause death rate was 20.0/1000 person-years of follow-up (n = 62 deaths). Causes of death included liver diseases (18), malignancies (14), AIDS-related (11); cardiovascular (9) and others (10). In a Cox analysis, age, AIDS diagnosis and chronic hepatitis were independent predictors of death.ConclusionsObserved CVD events in HIV-infected patients were well predicted by Framingham algorithm. Established major CVD risk factors are the strongest determinants of CVD morbidity in an Italian contemporary cohort of HIV-positive subjects. Interventions to modify traditional risk factors are urgently needed in HIV people.

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“… 15 , 16 , 17 , 18 , 19 Curiously, the Framingham risk score overestimated heart events in a Mediterranean HIV-infected population and a Regicor chart (an adaption for the characteristics of the Spanish population) worked better as a predictor for ischemic CV events. 20 Some intrinsic characteristics of this Spanish population may explain this different impact of Framingham score as it usually underestimates CV risk in HIV-infected populations. Only 26.1% of our patients were stratified as high-risk by Framingham compared to 46% by ACC/AHA.…”

Section: Discussionmentioning

confidence: 97%

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

Neto

Dias

Bressan

et al. 2017

The Brazilian Journal of Infectious Diseases

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The aim of this study was to compare the predictions of Framingham cardiovascular (CV) risk score (FRS) and the American College of Cardiology/American Heart Association (ACC/AHA) risk score in an HIV outpatient clinic in the city of Vitoria, Espirito Santo, Brazil. In a cross-sectional study 341 HIV infected patients over 40 years old consecutively recruited were interviewed. Cohen's kappa coefficient was used to assess agreement between the two algorithms. 61.3% were stratified as low risk by Framingham score, compared with 54% by ACC/AHA score (Spearman correlation 0.845; p<0.000). Only 26.1% were classified as cardiovascular high risk by Framingham compared to 46% by ACC/AHA score (Kappa=0.745; p<0.039). Only one out of eight patients had cardiovascular high risk by Framingham at the time of a myocardial infarction event registered up to five years before the study period. Both cardiovascular risk scores but especially Framingham underestimated high-risk patients in this HIV-infected population.

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The Framingham function overestimates the risk of ischemic heart disease in HIV-infected patients from Barcelona

Cited by 13 publications

References 23 publications

Predictive Performance of Cardiovascular Disease Risk Prediction Algorithms in People Living With HIV

Predictive Performance of Cardiovascular Disease Risk Prediction Algorithms in People Living With HIV

Observed versus predicted cardiovascular events and all-cause death in HIV infection: a longitudinal cohort study

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

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