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Cardiovascular risk prediction in HIV-infected patients: comparing the Framingham, atherosclerotic cardiovascular disease risk score (ASCVD), Systematic Coronary Risk Evaluation for the Netherlands (SCORE-NL) and Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) risk prediction models.
- Source :
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HIV medicine [HIV Med] 2016 Apr; Vol. 17 (4), pp. 289-97. Date of Electronic Publication: 2015 Aug 12. - Publication Year :
- 2016
-
Abstract
- Objectives: The aim of the study was to compare the predictions of five popular cardiovascular disease (CVD) risk prediction models, namely the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) model, the Framingham Heart Study (FHS) coronary heart disease (FHS-CHD) and general CVD (FHS-CVD) models, the American Heart Association (AHA) atherosclerotic cardiovascular disease risk score (ASCVD) model and the Systematic Coronary Risk Evaluation for the Netherlands (SCORE-NL) model.<br />Methods: A cross-sectional design was used to compare the cumulative CVD risk predictions of the models. Furthermore, the predictions of the general CVD models were compared with those of the HIV-specific D:A:D model using three categories (< 10%, 10-20% and > 20%) to categorize the risk and to determine the degree to which patients were categorized similarly or in a higher/lower category.<br />Results: A total of 997 HIV-infected patients were included in the study: 81% were male and they had a median age of 46 [interquartile range (IQR) 40-52] years, a known duration of HIV infection of 6.8 (IQR 3.7-10.9) years, and a median time on ART of 6.4 (IQR 3.0-11.5) years. The D:A:D, ASCVD and SCORE-NL models gave a lower cumulative CVD risk, compared with that of the FHS-CVD and FHS-CHD models. Comparing the general CVD models with the D:A:D model, the FHS-CVD and FHS-CHD models only classified 65% and 79% of patients, respectively, in the same category as did the D:A:D model. However, for the ASCVD and SCORE-NL models, this percentage was 89% and 87%, respectively. Furthermore, FHS-CVD and FHS-CHD attributed a higher CVD risk to 33% and 16% of patients, respectively, while this percentage was < 6% for ASCVD and SCORE-NL.<br />Conclusions: When using FHS-CVD and FHS-CHD, a higher overall CVD risk was attributed to the HIV-infected patients than when using the D:A:D, ASCVD and SCORE-NL models. This could have consequences regarding overtreatment, drug-related adverse events and drug-drug interactions.<br /> (© 2015 British HIV Association.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Anti-HIV Agents therapeutic use
Cardiovascular Diseases etiology
Cross-Sectional Studies
Female
HIV Infections complications
Humans
Male
Middle Aged
Models, Theoretical
Netherlands
Risk Assessment
United States
Young Adult
Anti-HIV Agents adverse effects
Antiretroviral Therapy, Highly Active adverse effects
Cardiovascular Diseases epidemiology
HIV Infections drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1468-1293
- Volume :
- 17
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- HIV medicine
- Publication Type :
- Academic Journal
- Accession number :
- 26268806
- Full Text :
- https://doi.org/10.1111/hiv.12300