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Increased risk of cardiovascular disease (CVD) with age in HIV-positive men: a comparison of the D:A:D CVD risk equation and general population CVD risk equations

(2014) HIV MEDICINE. 15(10). p.595-603
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Abstract
Objectives: The aim of the study was to statistically model the relative increased risk of cardiovascular disease (CVD) per year older in Data collection on Adverse events of anti-HIV Drugs (D:A:D) and to compare this with the relative increased risk of CVD per year older in general population risk equations. Methods: We analysed three endpoints: myocardial infarction (MI), coronary heart disease (CHD: MI or invasive coronary procedure) and CVD (CHD or stroke). We fitted a number of parametric age effects, adjusting for known risk factors and antiretroviral therapy (ART) use. The best-fitting age effect was determined using the Akaike information criterion. We compared the ageing effect from D:A:D with that from the general population risk equations: the Framingham Heart Study, CUORE and ASSIGN risk scores. Results: A total of 24323 men were included in analyses. Crude MI, CHD and CVD event rates per 1000 person-years increased from 2.29, 3.11 and 3.65 in those aged 40-45 years to 6.53, 11.91 and 15.89 in those aged 60-65 years, respectively. The best-fitting models included inverse age for MI and age + age(2) for CHD and CVD. In D:A:D there was a slowly accelerating increased risk of CHD and CVD per year older, which appeared to be only modest yet was consistently raised compared with the risk in the general population. The relative risk of MI with age was not different between D:A:D and the general population. Conclusions: We found only limited evidence of accelerating increased risk of CVD with age in D:A:D compared with the general population. The absolute risk of CVD associated with HIV infection remains uncertain.
Keywords
ageing, MORTALITY, cardiovascular disease, HIV, INFECTED PATIENTS, CORONARY-HEART-DISEASE, ANTIRETROVIRAL THERAPY, MYOCARDIAL-INFARCTION, COHORT, ASSOCIATION, VALIDATION, PROFILE, PREDICTION

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Citation

Please use this url to cite or link to this publication:

Chicago
Petoumenos, K, P Reiss, L Ryom, M Rickenbach, CA Sabin, W El-Sadr, AD Monforte, et al. 2014. “Increased Risk of Cardiovascular Disease (CVD) with Age in HIV-positive Men: a Comparison of the D:A:D CVD Risk Equation and General Population CVD Risk Equations.” Hiv Medicine 15 (10): 595–603.
APA
Petoumenos, K., Reiss, P., Ryom, L., Rickenbach, M., Sabin, C., El-Sadr, W., Monforte, A., et al. (2014). Increased risk of cardiovascular disease (CVD) with age in HIV-positive men: a comparison of the D:A:D CVD risk equation and general population CVD risk equations. HIV MEDICINE, 15(10), 595–603.
Vancouver
1.
Petoumenos K, Reiss P, Ryom L, Rickenbach M, Sabin C, El-Sadr W, et al. Increased risk of cardiovascular disease (CVD) with age in HIV-positive men: a comparison of the D:A:D CVD risk equation and general population CVD risk equations. HIV MEDICINE. 2014;15(10):595–603.
MLA
Petoumenos, K et al. “Increased Risk of Cardiovascular Disease (CVD) with Age in HIV-positive Men: a Comparison of the D:A:D CVD Risk Equation and General Population CVD Risk Equations.” HIV MEDICINE 15.10 (2014): 595–603. Print.
@article{5913865,
  abstract     = {Objectives: The aim of the study was to statistically model the relative increased risk of cardiovascular disease (CVD) per year older in Data collection on Adverse events of anti-HIV Drugs (D:A:D) and to compare this with the relative increased risk of CVD per year older in general population risk equations. 
Methods: We analysed three endpoints: myocardial infarction (MI), coronary heart disease (CHD: MI or invasive coronary procedure) and CVD (CHD or stroke). We fitted a number of parametric age effects, adjusting for known risk factors and antiretroviral therapy (ART) use. The best-fitting age effect was determined using the Akaike information criterion. We compared the ageing effect from D:A:D with that from the general population risk equations: the Framingham Heart Study, CUORE and ASSIGN risk scores. 
Results: A total of 24323 men were included in analyses. Crude MI, CHD and CVD event rates per 1000 person-years increased from 2.29, 3.11 and 3.65 in those aged 40-45 years to 6.53, 11.91 and 15.89 in those aged 60-65 years, respectively. The best-fitting models included inverse age for MI and age + age(2) for CHD and CVD. In D:A:D there was a slowly accelerating increased risk of CHD and CVD per year older, which appeared to be only modest yet was consistently raised compared with the risk in the general population. The relative risk of MI with age was not different between D:A:D and the general population. 
Conclusions: We found only limited evidence of accelerating increased risk of CVD with age in D:A:D compared with the general population. The absolute risk of CVD associated with HIV infection remains uncertain.},
  author       = {Petoumenos, K and Reiss, P and Ryom, L and Rickenbach, M and Sabin, CA and El-Sadr, W and Monforte, AD and Phillips, AN and De Wit, S and Kirk, O and Dabis, F and Pradier, C and Lundgren, JD and Law, MG and D:A:D Study group, on behalf of the and Vandekerckhove, Linos},
  issn         = {1464-2662},
  journal      = {HIV MEDICINE},
  keywords     = {ageing,MORTALITY,cardiovascular disease,HIV,INFECTED PATIENTS,CORONARY-HEART-DISEASE,ANTIRETROVIRAL THERAPY,MYOCARDIAL-INFARCTION,COHORT,ASSOCIATION,VALIDATION,PROFILE,PREDICTION},
  language     = {eng},
  number       = {10},
  pages        = {595--603},
  title        = {Increased risk of cardiovascular disease (CVD) with age in HIV-positive men: a comparison of the D:A:D CVD risk equation and general population CVD risk equations},
  url          = {http://dx.doi.org/10.1111/hiv.12162},
  volume       = {15},
  year         = {2014},
}

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