Level of agreement between frequently used cardiovascular risk calculators in people living with HIV. Issue 5 (14th March 2019)

• Record Type: Journal Article
• Authors: Dhillon, S; Sabin, CA; Alagaratnam, J; Bagkeris, E; Post, FA; Boffito, M; Anderson, J; Vera, J; Williams, I; Johnson, M; Sachikonye, M; Babalis, D; Mallon, PW; Winston, A
• Other Names: Ndoutoumou Amalia investigator.; Asboe David investigator.; Garvey Lucy investigator.; Pozniak Anton investigator.; Clarke Amanda investigator.; Bexley Andrew investigator.; Richardson Celia investigator.; Kirk Sarah investigator.; Gleig Rebecca investigator.; Bracchi Margherita investigator.; Pagani Nicole investigator.; Cerrone Maddalena investigator.; Bradshaw Daniel investigator.; Ferretti Francesca investigator.; Higgs Chris investigator.; Seah Elisha investigator.; Fletcher Stephen investigator.; Anthonipillai Michelle investigator.; Moyes Ashley investigator.; Deats Katie investigator.; Syed Irtiza investigator.; Matthews Clive investigator.; Fernando Peter investigator.; Chiwome Chido investigator.; Hardwick Shane investigator.; Mguni Sifiso investigator.; Clark Rebecca investigator.; Nevin‐Dolan Rhiannon investigator.; Pelluri Sambasivarao investigator.; Campbell Lucy investigator.; Yurdakul Selin investigator.; Okumu Sara investigator.; Pollard Louise investigator.; Santana‐Suarez Beatriz investigator.; Macken Alan investigator.; Ghavani‐Kia Bijan investigator.; Maher Joanne investigator.; Byrne Maria investigator.; Flaherty Ailbhe investigator.; Babu Sumesh investigator.; Otiko Damilola investigator.; Phillips Laura investigator.; Laverick Rosanna investigator.; Beynon Michelle investigator.; Salz Anna‐Lena investigator.; Severn Abigail investigator.; Underwood Jonathan investigator.; Tembo Lavender investigator.; Stott Matthew investigator.; McDonald Linda investigator.; Dransfield Felix investigator.; Whitehouse Andrew investigator.; Burgess Laura investigator.; Ngwu Nnenna investigator.; Hemat Nargis investigator.; Jones Martin investigator.; Carroll Anne investigator.; Kinloch Sabine investigator.; Youle Mike investigator.; Madge Sara investigator.;
• Is Part Of: HIV medicine. Volume 20:Issue 5(2019)
• Page Start: 347
• Page End: 352
• Publication Date: 2019-03-14
• Subjects: agreement -- cardiovascular risk prediction -- Data Collection on Adverse Events of Anti‐HIV Drugs (D:A:D) risk score -- Framingham -- HIV -- QRISK2; HIV infections -- Treatment -- Periodicals; HIV-positive persons -- Periodicals; HIV infections -- Treatment -- Decision making -- Periodicals; 616.9792
• DOI: 10.1111/hiv.12731
• Languages: English
• ISSNs: 1464-2662

Abstract

Abstract : Objectives: The aim of the study was to describe agreement between the QRISK2, Framingham and Data Collection on Adverse Events of Anti‐HIV Drugs (D:A:D) cardiovascular disease (CVD) risk calculators in a large UK study of people living with HIV (PLWH). Methods: PLWH enrolled in the Pharmacokinetic and Clinical Observations in People over Fifty (POPPY) study without a prior CVD event were included in this study. QRISK2, Framingham CVD and the full and reduced D:A:D CVD scores were calculated; participants were stratified into 'low' (< 10%), 'intermediate' (10–20%) and 'high' (> 20%) categories for each. Agreement between scores was assessed using weighted kappas and Bland–Altman plots. Results: The 730 included participants were predominantly male (636; 87.1%) and of white ethnicity (645; 88.5%), with a median age of 53 [interquartile range (IQR) 49–59] years. The median calculated 10‐year CVD risk was 11.9% (IQR 6.8–18.4%), 8.9% (IQR 4.6–15.0%), 8.5% (IQR 4.8–14.6%) and 6.9% (IQR 4.1–11.1%) when using the Framingham, QRISK2, and full and reduced D:A:D scores, respectively. Agreement between the different scores was generally moderate, with the highest level of agreement being between the Framingham and QRISK2 scores (weighted kappa = 0.65) but with most other kappa coefficients in the 0.50–0.60 range. Conclusions: Estimates of predicted 10‐year CVD risk obtained with commonly used CVD risk prediction tools demonstrate, in general, only moderate agreement among PLWH in the UK. While further validation with clinical endpoints is required, our findings suggest that care should be taken when interpreting any score alone.