Predicting the risk of cardiovascular disease in HIV-infected patients: The Data collection on Adverse Effects of Anti-HIV Drugs Study: European Journal of Cardiovascular Prevention and Rehabilitation

N. Friis-Møller, R. Thiébaut, P. Reiss, R. Weber, A.D. Monforte, S. De Wit, W. El-Sadr, E. Fontas, S. Worm, O. Kirk, A. Phillips, C.A. Sabin, J.D. Lundgren, M.G. Law, Ferran Torres

Research output: Contribution to journalArticleResearchpeer-review

281 Citations (Scopus)

Abstract

Aims: HIV-infected patients receiving combination antiretroviral therapy may experience metabolic complications, potentially increasing their risk of cardiovascular diseases (CVDs). Furthermore, exposures to some antiretroviral drugs seem to be independently associated with increased CVD risk. We aimed to develop cardiovascular risk-assessment models tailored to HIV-infected patients. Methods AND Results: Prospective multinational cohort study. The data set included 22 625 HIV-infected patients from 20 countries in Europe and Australia who were free of CVD at entry into the Data collection on Adverse Effects of Anti-HIV Drugs Study. Using cross-validation methods, separate models were developed to predict the risk of myocardial infarction, coronary heart disease, and a composite CVD endpoint. Model performance was compared with the Framingham score. The models included age, sex, systolic blood pressure, smoking status, family history of CVD, diabetes, total cholesterol, HDL cholesterol and indinavir, lopinavir/r and abacavir exposure. The models performed well with area under the receiver operator curve statistics of 0.783 (range 0.642-0.820) for myocardial infarction, 0.776 (0.670-0.818) for coronary heart disease and 0.769 (0.695-0.824) for CVD. The models estimated more accurately the outcomes in the subgroups than the Framingham score. Conclusion: Risk equations developed from a population of HIV-infected patients, incorporating routinely collected cardiovascular risk parameters and exposure to individual antiretroviral therapy drugs, might be more useful in estimating CVD risks in HIV-infected persons than conventional risk prediction models. © 2010 The European Society of Cardiology.
Original languageEnglish
Pages (from-to)491-501
Number of pages11
JournalEuropean Journal of Cardiovascular Prevention and Rehabilitation
Volume17
Issue number5
DOIs
Publication statusPublished - Oct 2010

Keywords

  • Antiretroviral drugs
  • cardiovascular risk
  • HIV
  • prediction model
  • abacavir
  • high density lipoprotein cholesterol
  • indinavir
  • lopinavir plus ritonavir
  • adult
  • age
  • article
  • cardiovascular disease
  • cholesterol blood level
  • clinical trial
  • controlled study
  • diabetes mellitus
  • female
  • gender
  • heart infarction
  • human
  • Human immunodeficiency virus infection
  • ischemic heart disease
  • major clinical study
  • male
  • multicenter study
  • prediction
  • priority journal
  • smoking
  • systolic blood pressure

Fingerprint

Dive into the research topics of 'Predicting the risk of cardiovascular disease in HIV-infected patients: The Data collection on Adverse Effects of Anti-HIV Drugs Study: European Journal of Cardiovascular Prevention and Rehabilitation'. Together they form a unique fingerprint.

Cite this