@article{3003241,
    title = "Detection of Subclinical Coronary Artery Lesions by Framingham Risk Score, Peripheral Artery Atheromatosis and Coronary Artery Calcium Score: A Pilot Study in Asymptomatic Individuals Living with HIV",
    author = "Kapelios, C.J. and Masouris, G. and Argyris, A. and Konstantinidis, I. and Gamaletsou, M.N. and Kontos, A. and Zormpala, A. and Spiliopoulos, S. and Sipsas, N.V. and Protogerou, A.D.",
    journal = "AIDS Research and Human Retroviruses",
    year = "2021",
    volume = "37",
    number = "5",
    pages = "343-349",
    publisher = "Mary Ann Liebert, Inc. 140 Huguenot Street, 3rd Floor New Rochelle, NY 10801 USA",
    issn = "0889-2229, 1931-8405",
    doi = "10.1089/aid.2021.0015",
    keywords = "adult;  Article;  atheromatosis;  carotid atherosclerosis;  clinical assessment;  computed tomographic angiography;  controlled study;  coronary artery calcium score;  coronary artery disease;  cross-sectional study;  female;  femoral artery;  Framingham risk score;  human;  Human immunodeficiency virus;  Human immunodeficiency virus infected patient;  major clinical study;  male;  middle aged;  pilot study;  prevalence;  priority journal;  ultrasound;  child;  complication;  coronary angiography;  coronary artery disease;  coronary blood vessel;  diagnostic imaging;  Human immunodeficiency virus infection;  predictive value;  risk assessment;  risk factor, calcium, Calcium;  Child;  Coronary Angiography;  Coronary Artery Disease;  Coronary Vessels;  HIV Infections;  Humans;  Male;  Pilot Projects;  Predictive Value of Tests;  Risk Assessment;  Risk Factors",
    abstract = "The incidence of acute coronary events is increased among people living with HIV (PLWH), but there is no risk estimation score, nor a surrogate biomarker able to predict subclinical coronary artery disease (sCAD). We assessed the performance of: (i) Framingham risk score (FRMs), (ii) peripheral (carotid and femoral) artery atheromatosis, and (iii) coronary artery calcium (CACs) score, to detect the presence of sCAD, in PLWH. In a cohort of PLWH free of cardiovascular disease (CVD), we measured sCAD and CACs by computed tomography, calculated FRMs, and assessed carotid/femoral plaques by ultrasound. In 56 participants (age: 49 ± 10 years, men: 88%, FRMs: 7.2 ± 6.9; mean number of carotid/femoral plaques: 1.4 ± 1.5; CACs >0 present in 59%, median CACs 0.9 [IQR 0-22]): (i) minimal sCAD (stenosis 1%-24%; present in 30%) and mild sCAD (25%-49%, 25%) were effectively detected by FRMs, number of plaques, and CACs [area under the curve (AUC) of CACs was better than that of both FRM and plaques, p < .05]; (ii) moderate sCAD (stenosis 50%-69%; present in 8.9%) was detected by number of plaques and CACs, but similar AUC (0.969 vs. 0.867, respectively, p = NS); and (iii) severe sCAD (70%-99%, present in only 3 [5.4%]) was detected only by CACs. A high prevalence of sCAD in asymptomatic PLWH free of CVD was detected; CACs is a highly efficient biomarker to detect all grades of sCAD, however, the number of carotid/femoral plaques combined is also a very promising - lower cost and radiation free - surrogate biomarker. Future, larger studies are needed to verify these results. © 2021 Mary Ann Liebert Inc."
}