Details:

Alternative Title:
Clin Infect Dis
Personal Author:
Thompson-Paul, Angela M. ; Lichtenstein, Kenneth A. ; Armon, Carl ; Palella, Frank J. ; Skarbinski, Jacek ; ... More +
Thompson-Paul, Angela M. ; Lichtenstein, Kenneth A. ; Armon, Carl ; Palella, Frank J. ; Skarbinski, Jacek ; Chmiel, Joan S. ; Hart, Rachel ; Wei, Stanley C. ; Loustalot, Fleetwood ; Brooks, John T. ; Buchacz, Kate Less -
Description:
Background

Cardiovascular disease (CVD) risk prediction tools are often applied to populations beyond those in which they were designed when validated tools for specific subpopulations are unavailable.

Methods

Using data from 2283 human immunodeficiency virus (HIV)–infected adults aged ≥18 years, who were active in the HIV Outpatient Study (HOPS), we assessed performance of 3 commonly used CVD prediction models developed for general populations: Framingham general cardiovascular Risk Score (FRS), American College of Cardiology/American Heart Association Pooled Cohort equations (PCEs), and Systematic COronary Risk Evaluation (SCORE) high-risk equation, and 1 model developed in HIV-infected persons: the Data Collection on Adverse Effects of Anti-HIV Drugs (D:A:D) study equation. C-statistics assessed model discrimination and the ratio of expected to observed events (E/O) and Hosmer-Lemeshow χ2P value assessed calibration.

Results

From January 2002 through September 2013, 195 (8.5%) HOPS participants experienced an incident CVD event in 15 056 person-years. The FRS demonstrated moderate discrimination and was well calibrated (C-statistic: 0.66, E/O: 1.01, P = .89). The PCE and D:A:D risk equations demonstrated good discrimination but were less well calibrated (C-statistics: 0.71 and 0.72 and E/O: 0.88 and 0.80, respectively; P < .001 for both), whereas SCORE performed poorly (C-statistic: 0.59, E/O: 1.72; P = .48).

Conclusions

Only the FRS accurately estimated risk of CVD events, while PCE and D:A:D underestimated risk. Although these models could potentially be used to rank US HIV-infected individuals at higher or lower risk for CVD, the models may fail to identify substantial numbers of HIV-infected persons with elevated CVD risk who could potentially benefit from additional medical treatment.


Subjects:
[+]
Article Cardiovascular Disease HIV Risk Prediction
Source:
Clin Infect Dis. 63(11):1508-1516.
Pubmed ID:
27613562
Pubmed Central ID:
PMC5624518
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:1b266936c68a25514a75a86efd4d28c62b7976d23f9974f9ca3c9e02809e1221
Download URL:
https://stacks.cdc.gov/view/cdc/48500/cdc_48500_DS1.pdf
File Type:

Supporting Files

• 	NIHMS863417-supplement-Supplemental_Tables.pdf	pdf
  	nihms863417.nxml	xml
  	nihms863417f1.gif	gif
  	nihms863417f1.jpg	jpeg

More +