Global cardiovascular risk in patients with HIV infection:: Concordance and differences in estimates according to three risk equations (Framingham, SCORE, and PROCAM)
Global cardiovascular risk in patients with HIV infection:: Concordance and differences in estimates according to three risk equations (Framingham, SCORE, and PROCAM)
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DOI：
10.1089/apc.2006.0165
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发表时间：
2007-07-01
影响因子：
4.9
通讯作者：
Pedro-Botet, Juan
中科院分区：
文献类型：
--
作者：
Knobel, Hernando;Jerico, Carlos;Pedro-Botet, Juan
为了比较根据Framingham、PROCAM（前瞻性心血管Mfinster）和SCORE（系统性冠状动脉风险评估）方程对HIV感染患者的心血管风险分层，2003年在门诊传染病科对760名HIV感染成人进行了一项横断面研究。使用Framingham和PROCAM（分别< 10%、10%-20%和>= 20%）和score（分别< 3%、3%-4%和>= 5%）方程检查心血管风险评分，并将患者分为低、中、高风险。Framingham组低、中、高心血管风险患者的患病率分别为76.6%、15.1%和8.3%，PROCAM组分别为90.1%、4.9%和5%，SCORE组分别为88.6%、3%和8.4%。这三个风险函数之间的一致性是显著的，但总体上是中等的（Framingham和PROCAM， ic 0.36, p < 0.0001； Framingham和SCORE， ic 0.32, p < 0.0001； PROCAM和SCORE， ic 0.46, p < 0.0001）。与PROCAM和SCORE相比，Framingham方程将hiv感染的男性患者中具有中度心血管风险的比例较高，而将低风险的比例较低（p < 0.0001）。目前的研究表明，无论使用何种评估的冠状动脉风险系统，hiv感染患者的低心血管风险发生率都很高。然而，与PROCAM和SCORE相比，hiv感染患者中的Framingham风险方程确定了更多具有中度心血管风险的男性患者。
To compare cardiovascular risk stratification according to Framingham, PROCAM (Prospective Cardiovascular Mfinster), and SCORE (Systematic Coronary Risk Evaluation) equations in patients with HIV infection, a cross-sectional study of a well-characterized cohort of 760 HIV-infected adults managed at the outpatient Infectious Disease Unit in 2003 was conducted. Cardiovascular risk score was examined and patients were classified as having low, moderate, or high risk using Framingham and PROCAM (< 10%, 10%-20%, and > 20%, respectively) and SCORE (< 3%,3%-4%, and >= 5%, respectively) equations. The prevalence of patients with low, moderate and high cardiovascular risk was 76.6%, 15.1%, and 8.3% by the Framingham, respectively, 90.1%, 4.9%, and 5% by the PROCAM, respectively, and 88.6%, 3%, and 8.4% by SCORE, respectively. Concordance between these three risk functions was significant, but globally moderate (Framingham and PROCAM, ic 0.36, p < 0.0001; Framingham and SCORE, ic 0.32, p < 0.0001; PROCAM and SCORE, ic 0.46, p < 0.0001). The Framingham equation categorized a higher proportion of HIV-infected male patients with moderate cardiovascular risk and a lower proportion of those with low risk (p < 0.0001) compared with PROCAM and SCORE. The present study showed a high prevalence of HIV-infected patients at low cardiovascular risk regardless of the assessed coronary risk system used. However, compared with PROCAM and SCORE, Framingham risk equation in HIV-infected patients identified a higher number of male patients with moderate cardiovascular risk.