Risk of cardiovascular events predicted by the Rama-EGAT score among HIV-infected patients in Thailand

Abstract

Cardiovascular disease has become an important cause of death among HIV-infected patients. A cross sectional study was conducted to determine the risk for cardiovascular events among HIV-infected patients who visited the Infectious Disease Clinic at Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. The risk for cardiovascular events was determined using the Rama-EGAT risk score. Patients were categorized into two groups by score: high risk group with a Rama-EGAT score ≥6 and low risk group with a Rama-EGAT score <6. One hundred nine patients were included in the study. The mean age of participants was 47.3 years old, 73 (67%) were male. Mean duration of HIV infection among participants was 8.5 years and the mean CD4 cell count was 485 cells/mm3. Nearly all the patients had received antiretroviral therapy. The mean body weight and body mass index (BMI) were 61.2 kg and 22.5 kg/m2, respectively. Of the 109 participants, 12 (11%) had a high risk for cardiovascular events. On multivariate analysis, older age [odds ratio (OR) per 5 years increase = 8.6; p=0.005], diabetes mellitus (OR = 63.1; p=0.020) and lower HDL (OR per 5 mg/dl decrease = 4.3, p=0.020) were factors significantly associated with high EGAT risk score. Early screening for diabetes mellitus and HDL levels, as well as appropriate glycemic control and regular exercise are crucial for preventing cardiovascular events among HIV-infected patients receiving antiretroviral therapy in Thailand.