Cardiovascular Disease Risk Prediction in the HIV Outpatient Study

Details

• Alternative Title:
  Clin Infect Dis
• Personal Author:
  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
  More +
• 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:
  • Adult
  • Anti-HIV Agents
  • Cardiovascular Diseases
  • Female
  • HIV Infections
  • Humans
  • Male
  • Medical Records
  • Middle Aged
  • Outpatients
  More +
• 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
• Volume:
  63
• Issue:
  11
• Download URL:
  https://stacks.cdc.gov/view/cdc/48500/cdc_48500_DS1.pdf
• File Type:
  [PDF - 537.56 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:1b266936c68a25514a75a86efd4d28c62b7976d23f9974f9ca3c9e02809e1221