Cardiovascular risk assessment in persons with HIV infection in the developing world: comparing three risk equations

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N Edwards-Jackson1, Sj Kerr, Hv Tieu

  • 1Columbia University College of Physicians & Surgeons, New York, USA.

HIV Medicine
|March 8, 2011
PubMed

Insights

Cardiovascular disease risk is low in Thai HIV patients. The Rama-EGAT and D:A:D equations showed good agreement for predicting risk in this population.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Cardiovascular disease (CVD) is a growing concern in HIV-infected individuals, particularly in developing nations.
  • Assessing CVD risk in this population is crucial for effective management and prevention strategies.

Purpose of the Study:

  • To evaluate the 10-year coronary heart disease (CHD) risk in a Thai HIV-infected cohort.
  • To compare the predictive accuracy of three distinct cardiovascular risk equations: Framingham, Rama-EGAT, and D:A:D.
  • To assess the agreement between these risk prediction models.

Main Methods:

  • Cross-sectional analysis of 785 Thai subjects from the HIV Netherlands Australia Thailand Collaboration (HIV-NAT) cohort (1996-2009).
  • Collection of cardiovascular risk factor history, laboratory, and clinical data.
  • Calculation of 10-year CHD risk using Framingham, Rama-EGAT, and D:A:D equations.

Main Results:

  • The cohort had a mean age of 41.0 years, with 55% males and a mean antiretroviral therapy duration of 7.7 years.
  • Prevalence of cardiovascular risk factors was low, with low high-density lipoprotein (HDL) being most common (36.3%).
  • High cardiovascular risk scores (≥10% 10-year CHD risk) were low: 9.9% (Framingham), 2.1% (Rama-EGAT), and 0.8% (D:A:D).

Conclusions:

  • The predicted cardiovascular risk in this Thai HIV-infected cohort was generally low.
  • The Rama-EGAT and D:A:D risk scores demonstrated good agreement, suggesting their suitability for estimating cardiovascular risk in this population.
  • The Framingham equation tended to overestimate cardiovascular risk compared to the other two models.
Abstract

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