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Cardiovascular risk in HIV-infected individuals: a comparison of three risk prediction algorithms

2019-07Journal article Open access
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dc.contributor.authorPolicarpo, Sara
dc.contributor.authorRodrigues, Teresa
dc.contributor.authorMoreira, Ana Catarina
dc.contributor.authorValadas, Emília
dc.date.accessioned2019-09-30T16:28:14Z
dc.date.available2019-09-30T16:28:14Z
dc.date.issued2019-07
dc.description.abstractABSTRACT - Introduction: Cardiovascular (CV) risk is known to be increased in HIV-infected individuals. Our aim was to assess CV risk in HIV-infected adults. Methods: CV risk was estimated for each patient using three different risk algorithms: SCORE, the Framingham risk score (FRS), and DAD. Patients were classified as at low, moderate or high CV risk. Clinical and anthropometric data were collected. Results: We included 571 HIV-infected individuals, mostly male (67.1%; n=383). Patients were divided into two groups according to antiretroviral therapy (ART): naïve (7.5%; n=43) or under ART (92.5%; n=528). The mean time since HIV diagnosis was 6.7±6.5 years in the naive group and 13.3±6.1 years in the ART group. Metabolic syndrome (MS) was identified in 33.9% (n=179) and 16.3% (n=7) of participants in the ART and naïve groups, respectively. MS was associated with ART (OR=2.7; p=0.018). Triglycerides ≥150 mg/dl (OR=13.643, p<0.001) was one of the major factors contributing to MS. Overall, high CV risk was found in 4.4% (n=23) of patients when the SCORE tool was used, in 20.5% (n=117) using the FRS, and in 10.3% (n=59) using the DAD score. The observed agreement between the FRS and SCORE was 55.4% (k=0.183, p<0.001), between the FRS and DAD 70.5% (k=0.465, p<0.001), and between SCORE and DAD 72.3% (k=0.347, p<0.001). Conclusion: On the basis of the three algorithms, we detected a high rate of high CV risk, particularly in patients under ART. The FRS was the algorithm that classified most patients in the high CV risk category (20.5%). In addition, a high prevalence of MS was identified in this patient group.pt_PT
dc.description.abstractRESUMO - Introdução: O risco cardiovascular (RCV) pode estar aumentado em indivíduos com infeção por Vírus Imunodeficiência Humana (VIH). O objetivo deste trabalho foi avaliar o RCV em adultos infetados por VIH. Métodos: O RCV foi estimado utilizando três algoritmos diferentes, Score, Framingham Risk Score (FRSs-CVD) e DAD; os participantes foram classificados apresentando RCV baixo, moderado ou elevado. Recolheram-se dados clínicos e antropométricos. Resultados: Incluíram-se 571 indivíduos, maioritariamente do género masculino (67,1%; n=383). Dividiram-se os participantes em dois grupos, com e sem terapêutica antirretroviral (cTAR): naïve (7,5%; n=43) versus cTAR (92,5%; n=528). O tempo médio desde o diagnóstico da infeção por VIH foi 6,7±6,5 anos no grupo naïve e 13,3±6,1 anos no grupo cART. A síndrome metabólica (SM) foi identificada em 33,9% (n=179) e em 16,3% (n=7) dos participantes, respetivamente no grupo cART e no grupo naïve. Verificou-se um RCV elevado em 4,4% (n=23) dos participantes, com recurso à ferramenta Score, em 20,5% (n=117) utilizando a FRSs e em 10,3% dos participantes (n=59) utilizando a ferramenta DAD. A concordância observada entre FRSs e Score foi 55,4% (k=0,183; p<0,001), entre FRSs e DAD 70,5% (k=0,465; p<0,001) e entre Score e DAD 72,3% (k=0,347; p<0,001). Conclusão: Com recurso aos algoritmos utilizados, identificou-se uma presença significativa de elevado RCV, sendo a ferramenta FRSs-CVD a que classificou mais indivíduos na categoria de RCV elevado (20,5%), e simultaneamente verificou-se uma prevalência elevada de SM.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationPolicarpo S, Rodrigues T, Moreira AC, Valadas E. Cardiovascular risk in HIV-infected individuals: a comparison of three risk prediction algorithms. Rev Port Cardiol. 2019;38(7):463-70.pt_PT
dc.identifier.doi10.1016/j.repc.2019.08.002pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.21/10525
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relation.publisherversionhttps://www.sciencedirect.com/science/article/pii/S0870255119304615?via%3Dihubpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectCardiovascular riskpt_PT
dc.subjectMetabolic syndromept_PT
dc.subjectHIV/Acquired immunodeficiency syndromept_PT
dc.subjectPortugalpt_PT
dc.titleCardiovascular risk in HIV-infected individuals: a comparison of three risk prediction algorithmspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage470pt_PT
oaire.citation.issue7pt_PT
oaire.citation.startPage463pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologíapt_PT
oaire.citation.volume38pt_PT
person.familyNameMoreira
person.givenNameAna Catarina
person.identifier.ciencia-idC81E-CC41-DFB0
person.identifier.orcid0000-0001-7031-6738
person.identifier.scopus-author-id16234261500
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationcdce3e88-b09d-40b9-bad5-29d1d3610f69
relation.isAuthorOfPublication.latestForDiscoverycdce3e88-b09d-40b9-bad5-29d1d3610f69

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