Validation of cardiovascular risk scores in people living with HIV in Colombia.

INTRODUCTION: People living with HIV (PLWH) have a higher risk of cardiovascular disease compared with the general population. The usefulness of traditional cardiovascular risk scores in this population has not been fully established in Colombia. OBJECTIVE: To evaluate and compare the predictive performance of different cardiovascular risk scores for the prediction of major adverse cardiovascular events in a cohort of people living with HIV. METHODS: A retrospective cohort study was conducted in 911 PLWH attended at a specialized institution in Bogotá between 2003 and 2014, with a ten-year follow-up. Cardiovascular risk scores were calculated using the Framingham, Framingham ATP III, Framingham adjusted for Colombia, PROCAM, DAD, and ASCVD models. Discriminative performance was assessed using the area under the curve (AUC) analysis. RESULTS: A low incidence of major adverse cardiovascular events (3.4%) was observed. All risk scores demonstrated apparently adequate discriminative capacity, with the ASCVD score showing the best performance (AUC 0.927; 95% CI: 0.87-0.98). A high correlation was observed among all evaluated risk scores (0.9). CONCLUSIONS: All evaluated risk scores showed apparently adequate discriminative and calibration capacity in this cohort of Colombian PLWH, with the ASCVD score showing the highest AUC. However, the low number of events, the retrospective design, and the absence of external validation limit the strength of these findings, which should be considered preliminary evidence pending confirmation through prospective, multicenter studies.