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Prediction of hard cardiovascular events in HIV patients

Raggi, P; De Francesco, D; Manicardi, M; Zona, S; Bellasi, A; Stentarelli, C; Carli, F; ... Guaraldi, G; + view all (2016) Prediction of hard cardiovascular events in HIV patients. Journal of Antimicrobial Chemotherapy , 71 (12) pp. 3515-3518. 10.1093/jac/dkw346. Green open access

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Abstract

OBJECTIVES: To assess the accuracy of risk prediction algorithms used in the general population and an HIV-specific algorithm to predict hard cardiovascular events. METHODS: We compared the pooled equation algorithm (PE) proposed by the American Heart Association with the Framingham risk score (FRS) and the HIV-specific DAD (Data Collection on Adverse Effects of Anti-HIV Drugs) algorithm in a cohort of 2550 HIV+ patients followed for 17 337 patient-years. RESULTS: During follow-up we recorded 67 myocardial infarctions and 2 cardiovascular deaths. PE and FRS identified and missed the same number of events (44 of 69 identified by PE and 49 of 69 by FRS). Similarly, DAD and FRS predicted and missed the same number of events (38 of 64 and 44 of 64 identified, respectively). All algorithms showed moderate sensitivity, specificity and positive predictive values, but high negative predictive values. However, PE and DAD identified more patients with no events than FRS (13.8% and 9.3% net reclassification improvement, respectively). CONCLUSIONS: All algorithms showed a modest predictive ability, although the PE and DAD algorithms identified more patients at low risk.

Type: Article
Title: Prediction of hard cardiovascular events in HIV patients
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/jac/dkw346
Publisher version: https://doi.org/10.1093/jac/dkw346
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: myocardial infarction, hiv, positive predictive value, American Heart Association, anti-HIV agents follow-up, cardiovascular event, cardiovascular death, framingham risk calculator, net reclassification improvement
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10042718
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