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High Concordance between D:A:Dr and the Framingham Risk Score in Brazilians Living with HIV

Vitor Souza1, Victória Valadares1, Thais Dias1

  • 1Department of Medicine, Medical School, Federal University of Bahia, Salvador 40110-060, BA, Brazil.

Viruses
|February 28, 2023
PubMed

Insights

Cardiovascular risk scores for people living with HIV (PLHIV) in Brazil were evaluated. The D:A:Dr score shows strong agreement with the Framingham Risk Score, suggesting it as a viable alternative for assessing cardiovascular risk in PLHIV.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • People living with HIV (PLHIV) face double the risk of cardiovascular diseases (CVD).
  • Accurate cardiovascular risk (CVR) assessment is crucial for PLHIV, yet no validated calculator exists for this population in Brazil.
  • Existing CVR tools may not fully capture the specific needs of PLHIV.

Purpose of the Study:

  • To evaluate the agreement between three cardiovascular risk scores in Brazilian PLHIV.
  • To determine the suitability of the Framingham Risk Score (FRS), Atherosclerotic Cardiovascular Disease (ASCVD) Risk Score, and the D:A:Dr score for assessing CVR in PLHIV.
  • To identify a reliable CVR calculator for PLHIV in Brazil.

Main Methods:

  • A cross-sectional study involving 265 PLHIV aged 40-74 years in Brazil.
  • Comparison of CVR using weighted Kappa coefficient and Bland-Altman plots for FRS, ASCVD, and D:A:Dr scores.
  • Analysis of demographic and clinical data, including age, sex, hypertension, and viral load.

Main Results:

  • Almost perfect agreement was found between the D:A:Dr score and FRS (k=0.82).
  • Substantial agreement was observed between FRS and ASCVD (k=0.74), and between D:A:Dr and ASCVD (k=0.70).
  • Increased discordance between scores was noted at higher CVR levels, as indicated by Bland-Altman plots.

Conclusions:

  • The Framingham Risk Score and the D:A:Dr score are adequate for classifying CVR in Brazilian PLHIV.
  • The D:A:Dr score is a suitable alternative to the FRS for assessing cardiovascular risk in this population in Brazil.
  • International guidelines support the use of D:A:Dr, reinforcing its utility for PLHIV care.

Keywords:
BrazilHIVcardiovascular risk

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