Cardiovascular risk assessment in people living with HIV compared to the general population.

Details

Serval ID
serval:BIB_9625723A86C9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cardiovascular risk assessment in people living with HIV compared to the general population.
Journal
European journal of preventive cardiology
Author(s)
Delabays B., Cavassini M., Damas J., Beuret H., Calmy A., Hasse B., Bucher H.C., Frischknecht M., Müller O., Méan M., Vollenweider P., Marques-Vidal P., Vaucher J.
ISSN
2047-4881 (Electronic)
ISSN-L
2047-4873
Publication state
Published
Issued date
30/03/2022
Peer-reviewed
Oui
Volume
29
Number
4
Pages
689-699
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
We prospectively assessed and compared the accuracy of cardiovascular risk scores in people living with HIV (PLWH) and individuals from the general population.
The Systematic Coronary Risk Evaluation Score 2 (SCORE2), the Pooled Cohort Equations (PCE), and the HIV-specific Data Collection on Adverse events of Anti-HIV Drugs (D:A:D) score were calculated in participants free from atherosclerotic cardiovascular disease (ASCVD) between 2003 and 2009. In total, 6373 [mean age, 40.6 years (SD, 9.9)] PLWH from the Swiss HIV Cohort Study (SHCS) and 5403 [52.8 years (SD, 10.7)] individuals from the CoLaus|PsyCoLaus study were eligible for analysis. We tested discrimination and calibration, and the value of adding HIV-specific factors to scores using the net reclassification improvement (NRI). During mean follow-ups of 13.5 (SD, 4.1) in SHCS and 9.9 (SD, 2.3) years in CoLaus|PsyCoLaus study, 533 (8.4%) and 374 (6.9%) people developed an incident ASCVD, respectively. This translated into age-adjusted incidence rates of 12.9 and 7.5 per 1000 person-year, respectively. In SHCS, SCORE2, PCE, and D:A:D presented comparable discriminative capacities [area under the receiver operating characteristic curve of 0.745 (95% confidence interval, CI, 0.723-0.767), 0.757 (95% CI, 0.736-0.777), and 0.763 (95% CI, 0.743-0.783)]. Adding HIV-specific variables (CD4 nadir and abacavir exposure) to SCORE2 and PCE resulted in an NRI of -0.1% (95% CI, -1.24 to 1, P = 0.83) and of 2.7% (95% CI, 0.3-5.1, P = 0.03), respectively.
PLWH present a two-fold higher rate of incident ASCVD compared to individuals from the general population. SCORE2 and PCE, which are clinically easier to use (reduced set of variables without adding HIV-specific factors), are valid to predict ASCVD in PLWH.
Keywords
Adult, Cardiovascular Diseases/diagnosis, Cardiovascular Diseases/epidemiology, Cardiovascular Diseases/etiology, Cohort Studies, HIV Infections/diagnosis, HIV Infections/drug therapy, HIV Infections/epidemiology, Heart Disease Risk Factors, Humans, Risk Assessment/methods, Risk Factors, Calibration, Cardiovascular, Discrimination, HIV, PLWH, Prevention, Risk score
Pubmed
Web of science
Open Access
Yes
Create date
20/12/2021 14:23
Last modification date
23/04/2022 6:35
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