Original scientific paper
https://doi.org/10.3325/cmj.2015.56.14
Comparison of four international cardiovascular disease prediction models and the prevalence of eligibility for lipid lowering therapy in HIV infected patients on antiretroviral therapy
Josip Begovac
; University Hospital for Infectious Diseases, Zagreb, Croatia
Gordana Dragović
; Department of Pharmacology,Clinical Pharmacology and Toxicology School of Medicine University of Belgrade, Belgrade, Serbia
Klaudija Višković
; University Hospital for Infectious Diseases, Zagreb, Croatia
Jovana Kušić
; HIV/AIDS Unit, Institute forInfectious and Tropical Diseases,School of Medicine, University of Belgrade, Belgrade, Serbia
Marta Perović Mihanović
; University Hospital for Infectious Diseases, Zagreb, Croatia
Davorka Lukas
; University Hospital for Infectious Diseases, Zagreb, Croatia
Đorđe Jevtović
; HIV/AIDS Unit, Institute forInfectious and Tropical Diseases,School of Medicine, University of Belgrade, Belgrade, Serbia
Abstract
Aim To compare four cardiovascular disease (CVD) risk models
and to assess the prevalence of eligibility for lipid lowering
therapy according to the 2013 American College of Cardiology/
American Heart Association (ACC/AHA) guidelines,
European AIDS Clinical Society Guidelines (EACS), and European
Society of Cardiology and the European Atherosclerosis
Society (ESC/EAS) guidelines for CVD prevention in HIV
infected patients on antiretroviral therapy.
Methods We performed a cross-sectional analysis of 254
consecutive HIV infected patients aged 40 to 79 years who
received antiretroviral therapy for at least 12 months. The
patients were examined at the HIV-treatment centers in
Belgrade and Zagreb in the period February-April 2011. We
compared the following four CVD risk models: the Framingham
risk score (FRS), European Systematic Coronary Risk
Evaluation Score (SCORE), the Data Collection on Adverse
Effects of Anti-HIV Drugs study (DAD), and the Pooled Cohort
Atherosclerotic CVD risk (ASCVD) equations.
Results The prevalence of current smoking was 42.9%, hypertension
31.5%, and hypercholesterolemia (>6.2 mmol/L)
35.4%; 33.1% persons were overweight, 11.8% were obese,
and 30.3% had metabolic syndrome. A high 5-year DAD
CVD risk score (>5%) had substantial agreement with the
elevated (≥7.5%) 10-year ASCVD risk equation score (kappa
= 0.63). 21.3% persons were eligible for statin therapy
according to EACS (95% confidence intervals [CI], 16.3%
to 27.4%), 25.6% according to ESC/EAS (95% CI, 20.2% to
31.9%), and 37.9% according to ACC/AHA guidelines (95%
CI, 31.6 to 44.6%).
Conclusion In our sample, agreement between the high
DAD CVD risk score and other CVD high risk scores was not
very good. The ACC/AHA guidelines would recommend statins
more often than ESC/EAS and EACS guidelines. Current
recommendations on treatment of dyslipidemia should be
applied with caution in the HIV infected population.
Keywords
Hrčak ID:
139292
URI
Publication date:
15.2.2015.
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