Cardiovascular risk assessment: a comparison of the Framingham, PROCAM, and DAD equations in HIV-infected persons

Max Weyler Nery, Celina Maria Turchi Martelli, Erika Aparecida Silveira, Clarissa Alencar de Sousa, Marianne de Oliveira Falco, Aline de Cássia Oliveira de Castro, Jorge Tannus Esper, Luis Carlos Silva e Souza, Marília Dalva Turchi, Max Weyler Nery, Celina Maria Turchi Martelli, Erika Aparecida Silveira, Clarissa Alencar de Sousa, Marianne de Oliveira Falco, Aline de Cássia Oliveira de Castro, Jorge Tannus Esper, Luis Carlos Silva e Souza, Marília Dalva Turchi

Abstract

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.

Figures

Figure 1
Figure 1
Prevalence of cardiovascular risk factors among 294 HIV-infected patients.
Figure 2
Figure 2
Prevalence of estimated CVD risk according to Framingham, Framingham with aggravating factors (Brazilian Guideline for Dyslipidemia and Atherosclerosis Prevention), PROCAM and DAD risk equations for 283 HIV-infected patients.

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