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

Area of Science:

• Cardiology
• Infectious Diseases
• Public Health

Background:

• HIV infection is associated with increased cardiovascular disease (CVD) risk.
• Accurate CVD risk assessment in HIV-infected individuals is crucial for preventive strategies.
• Existing CVD risk equations may perform differently in this population.

Purpose of the Study:

• To estimate the 10-year CVD risk in HIV-infected patients using multiple risk equations.
• To assess the agreement between the Framingham, Framingham with aggravating factors, PROCAM, and DAD equations.
• To evaluate the performance of these equations in a Brazilian HIV-infected cohort.

Main Methods:

• Cross-sectional study involving 294 HIV-infected adult outpatients in Brazil.
• Calculation of 10-year CVD risk using Framingham, Framingham with aggravating factors, PROCAM, and DAD equations.
• Assessment of agreement between equations using Cohen's kappa coefficient.

Main Results:

• The majority of participants were classified as low CVD risk across all equations.
• High-risk percentages varied significantly, from 0.4% (PROCAM) to 5.7% (Framingham with aggravating factors).
• Low HDL-C was the most frequent lipid abnormality (72.8%).

Conclusions:

• Different CVD risk equations yield substantially different risk estimations in HIV-infected patients.
• The Framingham equation with aggravating factors identified a higher proportion of high-risk individuals.
• While equation comparability is informative, their predictive accuracy for CVD outcomes in this population warrants further investigation.