Researchers, led by Marina Grand, stated that early detection of people with human immunodeficiency virus (HIV) who have a high-risk of cardiovascular disease (CVD) would allow for preventative actions. However, their study, published in Current HIV Research, contends that the most frequently recommended cardiovascular risk equations—including the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) model, the American Heart Association atherosclerotic cardiovascular disease risk score (ASCVD), and the Framingham Heart Study general CVD (FHS-CVD) model—as well as their cut-points, are controversial as to which is strongest at classifying high-risk individuals.
The study aimed to assess the agreement between cardiovascular risk levels assigned by D:A:D and 15 other risk equations, the equations’ ability to identify high-risk patients, and the optimal cut points for the prediction of carotid plaque presence as a surrogate for high-risk of cardiovascular disease.
A total of 86 adult patients with HIV were evaluated for cardiovascular risk using multiple risk scoring tools. According to the investigators, the risk equations demonstrated a “significant and positive correlation with plaque presence.” They also observed that the ASCVD and D:A:D equations had higher high-risk detection. Lastly, full D:A:D5y>0.88%, ASCVD>2.80%, and FRS:CVD>2.77% each corresponded to an 80% sensitivity.
After their analysis, Grand and colleagues concluded that all cardiovascular risk equations underestimate the true risk for developing CVD in patients with HIV and that “the cut-points for high cardiovascular risk were found to vary greatly from recommended in clinical guidelines.”
Source: Current HIV Research