Long-term predictive value of the Framingham Risk Score for Stroke in HIV-positive vs HIV-negative men

BackgroundSLE is an independent risk factor for cardiovascular disease (CVD). This study aimed to determine which among QRISK2, QRISK3, Framingham Risk Score (FRS), modified Framingham Risk Score (mFRS) and SLE Cardiovascular Risk Equation (SLECRE) best predicts CVD.MethodsThis is a single-centre analysis on 1887 patients with SLE followed prospectively according to a standard protocol. Tools’ scores were evaluated against CVD development at/within 10 years for patients with CVD and without CVD. For patients with CVD, the index date for risk score calculation was chosen as close to 10 years prior to CVD event. For patients without CVD, risk scores were calculated as close to 10 years prior to the most recent clinic appointment. Proportions of low-risk (<10%), intermediate-risk (10%–20%) and high-risk (>20%) patients for developing CVD according to each tool were determined, allowing sensitivity, specificity, positive/negative predictive value and concordance (c) statistics analysis.ResultsAmong 1887 patients, 232 CVD events occurred. QRISK2 and FRS, and QRISK3 and mFRS, performed similarly. SLECRE classified the highest number of patients as intermediate and high risk. Sensitivities and specificities were 19% and 93% for QRISK2, 22% and 93% for FRS, 46% and 83% for mFRS, 47% and 78% for QRISK3, and 61% and 64% for SLECRE. Tools were similar in negative predictive value, ranging from 89% (QRISK2) to 92% (SLECRE). FRS and mFRS had the greatest c-statistics (0.73), while QRISK3 and SLECRE had the lowest (0. 67).ConclusionmFRS was superior to FRS and was not outperformed by the QRISK tools. SLECRE had the highest sensitivity but the lowest specificity. mFRS is an SLE-adjusted practical tool with a simple, intuitive scoring system reasonably appropriate for ambulatory settings, with more research needed to develop more accurate CVD risk prediction tools in this population.

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A STUDY OF THE CARDIAC MANIFESTATIONS IN HIV POSITIVE INDIVIDUALS AND ITS CORRELATION WITH DISEASE SEVERITY AND FRAMINGHAM RISK SCORE

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2015/725 ◽

2015 ◽

Vol 2 (34) ◽

pp. 5211-5219 ◽

Cited By ~ 1

Author(s):

Sudagar Singh R B ◽

Vengadakrishnan K ◽

Kawin Gunasekaran ◽

Damodharan J

Keyword(s):

Disease Severity ◽

Risk Score ◽

Framingham Risk Score ◽

Hiv Positive ◽

Framingham Risk ◽

Cardiac Manifestations

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P5088Significant reduction of Framingham risk score in hypogonadal men receiving long-term testosterone therapy: real-life evidence from a 10-year registry

European Heart Journal ◽

10.1093/eurheartj/ehy566.p5088 ◽

2018 ◽

Vol 39 (suppl_1) ◽

Author(s):

F Saad ◽

A Haider ◽

K S Haider ◽

K Huang ◽

X Xu

Keyword(s):

Risk Score ◽

Framingham Risk Score ◽

Real Life ◽

Testosterone Therapy ◽

Framingham Risk

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Longitudinal Progression of Subclinical Coronary Atherosclerosis in Swiss HIV-Positive Compared With HIV-Negative Persons Undergoing Coronary Calcium Score Scan and CT Angiography

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa438 ◽

2020 ◽

Vol 7 (10) ◽

Author(s):

Philip E Tarr ◽

Bruno Ledergerber ◽

Alexandra Calmy ◽

Thanh Doco-Lecompte ◽

Isabella C Schoepf ◽

...

Keyword(s):

Hiv Infection ◽

Risk Score ◽

Framingham Risk Score ◽

Subclinical Atherosclerosis ◽

The United States ◽

Related Factors ◽

Coronary Segment ◽

Framingham Risk ◽

Hiv Negative

Abstract Background People with HIV (HIV+) may have increased cardiovascular event rates compared with HIV-negative (HIV-) persons. Cross-sectional data from the United States and Switzerland, based on coronary artery calcium scan (CAC) and coronary computed tomography angiography (CCTA), suggest, respectively, increased and similar prevalence of subclinical atherosclerosis in HIV+ vs HIV- persons. Methods We repeated CAC/CCTA in 340 HIV+ and 90 HIV- study participants >2 years after baseline CAC/CCTA. We assessed the association of HIV infection, Framingham risk score (FRS), and HIV-related factors with the progression of subclinical atherosclerosis. Results HIV+ were younger than HIV- participants (median age, 52 vs 56 years; P < .01) but had similar median 10-year FRS (8.9% vs 9.0%; P = .82); 94% had suppressed HIV viral load. In univariable and multivariable analyses, FRS was associated with the incidence rate ratio (IRR) of new subclinical atherosclerosis at the follow-up CAC/CCTA, but HIV infection was not: any plaque (adjusted IRR for HIV+ vs HIV- participants, 1.21; 95% CI, 0.62–2.35), calcified plaque (adjusted IRR for HIV+ vs HIV- participants, 1.06; 95% CI, 0.56–2), noncalcified/mixed plaque (adjusted IRR for HIV+ vs HIV- participants, 1.24; 95% CI, 0.69–2.21), and high-risk plaque (adjusted IRR for HIV+ vs HIV- participants, 1.46; 95% CI, 0.66–3.20). Progression of CAC score between baseline and follow-up CAC/CCTA was similar in HIV+ (median annualized change [interquartile range {IQR}], 0.41 [0–10.19]) and HIV- participants (median annualized change [IQR], 2.38 [0–16.29]; P = .11), as was progression of coronary segment severity score (HIV+: median annualized change [IQR], 0 [0–0.47]; HIV-: median annualized change [IQR], 0 [0–0.52]; P = .10) and coronary segment involvement score (HIV+: median annualized change [IQR], 0 [0–0.45]; HIV-: median annualized change [IQR], 0 [0–0.41]; P = .25). Conclusions In this longitudinal CAC/CCTA study from Switzerland, Framingham risk score was associated with progression of subclinical atherosclerosis, but HIV infection was not.

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P2389Head-to-head comparison between framingham risk score, cacs, ccta, spect and hybrid spect/ccta in long-term prediction of major adverse cardiac events

European Heart Journal ◽

10.1093/eurheartj/ehx502.p2389 ◽

2017 ◽

Vol 38 (suppl_1) ◽

Author(s):

O.F. Clerc ◽

T.A. Fuchs ◽

S. Dougoud ◽

A.P. Pazhenkottil ◽

O. Gaemperli ◽

...

Keyword(s):

Risk Score ◽

Framingham Risk Score ◽

Major Adverse Cardiac Events ◽

Cardiac Events ◽

Term Prediction ◽

Framingham Risk ◽

Adverse Cardiac Events ◽

Long Term Prediction

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Coronary Artery Calcification and Plaque Characteristics in People Living With HIV: A Systematic Review and Meta‐Analysis

Journal of the American Heart Association ◽

10.1161/jaha.120.019291 ◽

2021 ◽

Vol 10 (19) ◽

Author(s):

Cullen Soares ◽

Amjad Samara ◽

Matthew F. Yuyun ◽

Justin B. Echouffo‐Tcheugui ◽

Ahmad Masri ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Calcium ◽

Framingham Risk Score ◽

Meta Analysis ◽

Hiv Positive ◽

People Living With Hiv ◽

Framingham Risk ◽

Noncalcified Plaque ◽

Living With Hiv ◽

Hiv Negative

Background Studies have reported that people living with HIV have higher burden of subclinical cardiovascular disease, but the data are not adequately synthesized. We performed meta‐analyses of studies of coronary artery calcium and coronary plaque in people living with HIV. Methods and Results We performed systematic search in electronic databases, and data were abstracted in standardized forms. Study‐specific estimates were pooled using meta‐analysis. 43 reports representing 27 unique studies and involving 10 867 participants (6699 HIV positive, 4168 HIV negative, mean age 52 years, 86% men, 32% Black) were included. The HIV‐positive participants were younger (mean age 49 versus 57 years) and had lower Framingham Risk Score (mean score 6 versus 18) compared with the HIV‐negative participants. The pooled estimate of percentage with coronary artery calcium >0 was 45% (95% CI, 43%–47%) for HIV‐positive participants, and 52% (50%–53%) for HIV‐negative participants. This difference was no longer significant after adjusting for difference in Framingham Risk Score between the 2 groups. The odds ratio of coronary artery calcium progression for HIV‐positive versus ‐negative participants was 1.64 (95% CI, 0.91–2.37). The pooled estimate for prevalence of noncalcified plaque was 49% (95% CI, 47%–52%) versus 20% (95% CI, 17%–23%) for HIV‐positive versus HIV‐negative participants, respectively. Odds ratio for noncalcified plaque for HIV‐positive versus ‐negative participants was 1.23 (95% CI, 1.08–1.38). There was significant heterogeneity that was only partially explained by available study‐level characteristics. Conclusions People living with HIV have higher prevalence of noncalcified coronary plaques and similar prevalence of coronary artery calcium, compared with HIV‐negative individuals. Future studies on coronary artery calcium and plaque progression can further elucidate subclinical atherosclerosis in people living with HIV.

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