Key result
SCORE and DAD risk algorithms were superior to FRS and PROCAM, as only 7.1% of patients classified as low risk by SCORE and DAD had subclinical atherosclerosis compared to 61.9% and 81.0% by FRS and PROCAM.
Why the study?
Do SCORE and DAD risk algorithms better identify subclinical atherosclerosis compared to FRS and PROCAM in young HIV-infected male patients?
Cross-Sectional (n=83)
No
Do SCORE and DAD risk algorithms better identify subclinical atherosclerosis compared to FRS and PROCAM in young HIV-infected male patients?
Absolute Event Rate: 7.1% vs 61.9%
p-value: p=<0.001
SCORE and DAD risk algorithms are superior to FRS and PROCAM in identifying subclinical atherosclerosis in young HIV-infected men, suggesting their preferred use for CVD risk stratification in this population.
May support SCORE/DAD over FRS/PROCAM for low-risk stratification in young HIV men; leaves open prospective validation before practice change.
INTRODUCTION: Traditional cardiovascular (CVD) risk assessment algorithms such as the Framingham Risk Score (FRS), Systematic Coronary Risk Evaluation (SCORE) and Prospective Cardiovascular Munster (PROCAM) were developed for general populations, their usefulness in HIV-infected population has not been confirmed. DAD algorithm was developed specifically for HIV-infected patients. The aim of our study was to evaluate the performance of risk assessment algorithms in HIV-infected population. METHODS: A prospective cross-sectional national study that included 83 HIV-infected male patients from Slovenia below the age of 55 was performed. CVD risk was assessed using four algorithms, the presence of subclinical atherosclerosis was determined by measuring carotid intima-media thickness (CIMT); patients were followed up for 5 years. RESULTS: High proportion of patients with low CVD risk according to FRS (61.9%) and PROCAM (81.0%) and only 7.1% according to SCORE had evidence of subclinical atherosclerosis. Only 7.1% of patients with low CVD risk according to DAD algorithm had evidence of subclinical atherosclerosis. CONCLUSION: Our study has shown that SCORE and DAD algorithm were superior to FRS and PROCAM. In younger HIV-infected patients, even with moderate CVD risk, CIMT assessment should be employed in a complete clinical evaluation as a more aggressive prevention and treatment approach is warranted.
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Pirš et al. (2014) conducted a cross-sectional in HIV infection (n=83). SCORE and DAD risk algorithms vs. Framingham Risk Score (FRS) and PROCAM algorithms was evaluated on Proportion of patients with subclinical atherosclerosis (CIMT > 0.8mm) misclassified as having low cardiovascular risk (p=<0.001). SCORE and DAD risk algorithms were superior to FRS and PROCAM, as only 7.1% of patients classified as low risk by SCORE and DAD had subclinical atherosclerosis compared to 61.9% and 81.0% by FRS and PROCAM.
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