Department of Medicine, Medical School, Federal University of Bahia, Salvador 40110-060, BA, Brazil.
Hospital Universitário Professor Edgard Santos, UFBA-EBSEHR, Salvador 40110-060, BA, Brazil.
Viruses. 2023 Jan 26;15(2):348. doi: 10.3390/v15020348.
People living with HIV (PLHIV) have twice the risk of developing cardiovascular diseases, making it essential to identify high cardiovascular risk (CVR). However, there is no validated CVR calculator for PLHIV in Brazil. We performed a cross-sectional study with 265 individuals living with HIV, aged 40 to 74 years, to assess the agreement between three CVR scores: Framingham Risk Score (FRS), Atherosclerotic Cardiovascular Disease (ASCVD) Risk Score, and a specific for PLHIV, Reduced Data Collection on Adverse Effects of Anti-HIV Drugs (D:A:Dr). We assessed agreement using the weighted Kappa coefficient and the Bland-Altman plot. The median age was 52 years (47-58), 58.9% were men, 34% were hypertensive and 8.3% had a detectable viral load. There was an almost perfect agreement between D:A:Dr x FRS (k = 0.82; 95% CI 0.77-0.87; < 0.001), and substantial agreement between FRS vs. ASCVD (k = 0.74; 95% CI 0.69-0.79; < 0.001) and between D:A:Dr vs. ASCVD (k = 0.70; 95% CI 0.64-0.76; < 0.001). The Bland-Altman plot revealed greater discordance between scores as the CVR increased. Our results suggest that the FRS and the D:A:Dr are adequate to classify the CVR in this population, and the D:A:Dr score can be used as an alternative to the FRS in Brazil, as other international guidelines have already advocated.
艾滋病毒感染者(PLHIV)患心血管疾病的风险是一般人群的两倍,因此识别高心血管风险(CVR)至关重要。然而,巴西尚未有针对 PLHIV 的经验证的 CVR 计算器。我们进行了一项横断面研究,纳入了 265 名年龄在 40 至 74 岁之间的艾滋病毒感染者,以评估三种 CVR 评分(Framingham 风险评分(FRS)、动脉粥样硬化性心血管疾病(ASCVD)风险评分和针对 PLHIV 的特定评分,即减少抗 HIV 药物不良反应数据收集(D:A:Dr)之间的一致性。我们使用加权 Kappa 系数和 Bland-Altman 图评估一致性。中位年龄为 52 岁(47-58),58.9%为男性,34%为高血压患者,8.3%的患者可检测到病毒载量。D:A:Dr x FRS 之间存在几乎完美的一致性(k = 0.82;95%CI 0.77-0.87;<0.001),FRS 与 ASCVD 之间存在显著一致性(k = 0.74;95%CI 0.69-0.79;<0.001),D:A:Dr 与 ASCVD 之间也存在显著一致性(k = 0.70;95%CI 0.64-0.76;<0.001)。Bland-Altman 图显示,随着 CVR 的增加,评分之间的差异更大。我们的研究结果表明,FRS 和 D:A:Dr 可以充分用于对该人群的 CVR 进行分类,D:A:Dr 评分可以作为巴西 FRS 的替代方法,因为其他国际指南已经提倡使用该评分。