Infect Chemother.  2022 Sep;54(3):409-418. 10.3947/ic.2022.0048.

Comparison of Three Cardiovascular Risk Scores among HIV-Infected Patients in Korea: The Korea HIV/AIDS Cohort Study

Affiliations
  • 1Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
  • 2Department of Statistics and Data Science, College of Commerce and Economics, Yonsei University, Seoul, Korea
  • 3Department of Applied Statistics, College of Commerce and Economics, Yonsei University, Seoul, Korea
  • 4Institute for Health and Society, Hanyang University, Seoul, Korea
  • 5Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
  • 6Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea
  • 7Division of Infectious Diseases, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 8Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea

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.

Keyword

HIV; Korea; Cardiovascular diseases; Coronary disease
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