Comparison of Three Cardiovascular Risk Scores among HIV-Infected Patients in Korea: The Korea HIV/AIDS Cohort Study
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Background: We investigated cardiovascular disease (CVD), risk factors for CVD, and applicability of the three known CVD risk equations in the Korean human immunodeficiency virus/ Acquired Immune Deficiency Syndrome (HIV/AIDS) cohort. Materials and methods: The study parcitipants were HIV-infected patients in a Korean HIV/AIDS cohort enrolled from 19 hospitals between 2006 and 2017. Data collected at entry to the cohort were analyzed. The 5-year CVD risk in each participant was calculated using three CVD risk equations: reduced CVD prediction model of HIV-specific data collection on adverse effects of anti-HIV drugs (R-DAD), Framingham general CVD risk score (FRS), and Korean Coronary Heart Disease Risk Score (KRS). Results: CVD events were observed in 11 of 586 HIV-infected patients during a 5-year (median) follow-up period. The incidence of CVD was 4.11 per 1,000 person-years. Older age (64 vs. 41 years, P = 0.005) and diabetes mellitus (45.5% vs. 6.4%, P <0.001) were more frequent in patients with CVD. Using R-DAD, FRS, and KRS, 1.9%, 2.4%, and 0.7% of patients, respectively, were considered to have a very high risk (≥10%) of 5-year CVD. The discriminatory capacities of the three prediction models were good, with c-statistic values of 0.829 (P <0.001) for R-DAD, 0.824 (P <0.001) for FRS, and 0.850 (P = 0.001) for KRS. Conclusion: The FRS, R-DAD, and KRS performed well in the Korean HIV/AIDS cohort. A larger cohort and a longer period of follow-up may be necessary to demonstrate the risk factors and develop an independent CVD risk prediction model specific to Korean patients with HIV.
Abstract
Background: We investigated cardiovascular disease (CVD), risk factors for CVD, and applicability of the three known CVD risk equations in the Korean human immunodeficiency virus/ Acquired Immune Deficiency Syndrome (HIV/AIDS) cohort. Materials and methods: The study parcitipants were HIV-infected patients in a Korean HIV/AIDS cohort enrolled from 19 hospitals between 2006 and 2017. Data collected at entry to the cohort were analyzed. The 5-year CVD risk in each participant was calculated using three CVD risk equations: reduced CVD prediction model of HIV-specific data collection on adverse effects of anti-HIV drugs (R-DAD), Framingham general CVD risk score (FRS), and Korean Coronary Heart Disease Risk Score (KRS). Results: CVD events were observed in 11 of 586 HIV-infected patients during a 5-year (median) follow-up period. The incidence of CVD was 4.11 per 1,000 person-years. Older age (64 vs. 41 years, P = 0.005) and diabetes mellitus (45.5% vs. 6.4%, P <0.001) were more frequent in patients with CVD. Using R-DAD, FRS, and KRS, 1.9%, 2.4%, and 0.7% of patients, respectively, were considered to have a very high risk (≥10%) of 5-year CVD. The discriminatory capacities of the three prediction models were good, with c-statistic values of 0.829 (P <0.001) for R-DAD, 0.824 (P <0.001) for FRS, and 0.850 (P = 0.001) for KRS. Conclusion: The FRS, R-DAD, and KRS performed well in the Korean HIV/AIDS cohort. A larger cohort and a longer period of follow-up may be necessary to demonstrate the risk factors and develop an independent CVD risk prediction model specific to Korean patients with HIV.
참고문헌 (34)
- McManus H, "Long-term survival in HIV positive patients with up to 15Years of antiretroviral therapy", PLoS One, 7, pp.e48839~ (2012)
- Hasse B, "Morbidity and aging in HIV-infected persons : the Swiss HIV cohort study", Clin Infect Dis, 53, pp.1130~1139 (2011)
- Ryom L, "Association between antiretroviral exposure and renal impairment among HIV-positive persons with normal baseline renal function : the D : A : D study", J Infect Dis, 207, pp.1359~1369 (2013)
- Freiberg MS, "HIV infection and the risk of acute myocardial infarction", JAMA Intern Med, 173, pp.614~622 (2013)
- Rotger M, "Contribution of genetic background, traditional risk factors, and HIV-related factors to coronary artery disease events in HIV-positive persons", Clin Infect Dis, 57, pp.112~121 (2013)
- Nery MW, "Cardiovascular risk assessment : a comparison of the Framingham, PROCAM, and DAD equations in HIV-infected persons", Sci World J, 2013, pp.969281~ (2013)
- D’Agostino RB Sr, "General cardiovascular risk profile for use in primary care : the Framingham Heart Study", Circulation, 117, pp.743~753 (2008)
- Friis-Møller N, "Predicting the risk of cardiovascular disease in HIV-infected patients : the data collection on adverse effects of anti-HIV drugs study", Eur J Cardiovasc Prev Rehabil, 17, pp.491~501 (2010)
- Jee SH, "A coronary heart disease prediction model : the Korean Heart Study", BMJ Open, 4, pp.e005025~ (2014)
- 최보율, "Korea HIV", AIDS Cohort Study: study design and baseline characteristics, 2018, pp.40, 1~8[DOI]
- 최윤수, "Epidemiological characteristics of HIV infected Korean: Korea HIV", AIDS Cohort Study, 2019, pp.41, 1~9[DOI]
- Anderson KM, "Cardiovascular disease risk profiles", Am Heart J, 121, pp.293~298 (1991)
- Friis-Møller N, "An updated prediction model of the global risk of cardiovascular disease in HIV-positive persons : The data-collection on adverse effects of anti-HIV drugs(D : A : D)study", Eur J Prev Cardiol, 23, pp.214~223 (2016)
- Yusuf S, "Global burden of cardiovascular diseases : Part II : variations in cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies", Circulation, 104, pp.2855~2864 (2001)
- Rabanal KS, "Ethnic differences in risk factors and total risk of cardiovascular disease based on the Norwegian CONOR study", Eur J Prev Cardiol, 20, pp.1013~1021 (2013)
- Rabanal KS, "Ethnic inequalities in acute myocardial infarction and stroke rates in Norway 1994-2009 : a nationwide cohort study(CVDNOR)", BMC Public Health, 15, pp.1073~ (2015)
- Strategies for Management of Antiretroviral Therapy (SMART) Study Group, "CD4+ count-guided interruption of antiretroviral treatment", N Engl J Med, 355, pp.2283~2296 (2006)
- Kuller LH, "Inflammatory and coagulation biomarkers and mortality in patients with HIV infection", PLoS Med, 5, pp.e203~ (2008)
- Phillips AN, "Interruption of antiretroviral therapy and risk of cardiovascular disease in persons with HIV-1 infection : exploratory analyses from the SMART trial", Antivir Ther, 13, pp.177~187 (2008)
- French MA, "Serum immune activation markers are persistently increased in patients with HIV infection after 6 years of antiretroviral therapy despite suppression of viral replication and reconstitution of CD4+ T cells", J Infect Dis, 200, pp.1212~1215 (2009)
- Hsue PY, "Role of viral replication, antiretroviral therapy, and immunodeficiency in HIV-associated atherosclerosis", AIDS, 23, pp.1059~1067 (2009)
- Nordell AD, "Severity of cardiovascular disease outcomes among patients with HIV is related to markers of inflammation and coagulation", J Am Heart Assoc, 3, pp.e000844~ (2014)
- DAD Study Group, "Friis-Møller N, Reiss P, Sabin CA, Weber R, Monforte Ad, El-Sadr W, Thiébaut R, De Wit S, Kirk O, Fontas E, Law MG, Phillips A, Lundgren JD. Class of antiretroviral drugs and the risk of myocardial infarction", N Engl J Med, 356, pp.1723~1735 (2007)
- D:A:D Study Group, "Use of nucleoside reverse transcriptase inhibitors and risk of myocardial infarction in HIV-infected patients enrolled in the D : A : D study : a multi-cohort collaboration", Lancet, 371, pp.1417~1426 (2008)
- Liu J, "Predictive value for the Chinese population of the Framingham CHD risk assessment tool compared with the Chinese Multi-Provincial Cohort Study", JAMA, 291, pp.2591~2599 (2004)
- Ahn KA, "Framingham equation model overestimates risk of ischemic heart disease in Korean men and women", Korean J Epidemiol, 28, pp.162~170 (2006)
- Triant VA, "Cardiovascular risk prediction functions underestimate risk in HIV infection", Circulation, 137, pp.2203~2214 (2018)
- Kim SB, "A comparison of the predicted risk for cardiovascular disease between HIV-infected and uninfected persons in Korea", Scand J Infect Dis, 45, pp.855~862 (2013)
- Noumegni SR, "Assessment of the agreement between the Framingham and DAD risk equations for estimating cardiovascular risk in adult Africans living with HIV infection : a cross-sectional study", Trop Dis Travel Med Vaccines, 3, pp.12~ (2017)
- Begovac J, "Comparison of four international cardiovascular disease prediction models and the prevalence of eligibility for lipid lowering therapy in HIV infected patients on antiretroviral therapy", Croat Med J, 56, pp.14~23 (2015)
- Policarpo S, "Cardiovascular risk in HIV-infected individuals: A comparison of three risk prediction algorithms", Rev Port Cardiol(Engl Ed), 38, pp.463~470 (2019)
- Dhillon S, "Level of agreement between frequently used cardiovascular risk calculators in people living with HIV", HIV Med, 20, pp.347~352 (2019)
- Mashinya F, "Assessment of cardiovascular risk factors in people with HIV infection treated with ART in rural South Africa : a cross sectional study", AIDS Res Ther, 12, pp.42~ (2015)
- Pirš M, "Cardiovascular risk assessment in HIVinfected male patients : a comparison of Framingham, SCORE, PROCAM and DAD risk equations", Acta Dermatovenerol Alp Panonica Adriat, 23, pp.43~47 (2014)