No improvement in myocardial infarction risk-model performance with addition of HIV-specific factors
WEDNESDAY, Dec. 21, 2016 (HealthDay News) — For adults with HIV, the Pooled Cohort Equations discriminate myocardial infarction (MI) risk, with no improvement in model performance with addition of HIV-specific factors, according to a study published online Dec. 21 in JAMA Cardiology.
Matthew J. Feinstein, M.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues examined the extent to which existing and de novo estimation tools predict MI in a multicenter HIV cohort. The performance of standard of care and two new data-derived MI risk estimation models were assessed at five Centers for AIDS Research Network of Integrated Clinical System sites. Included in the assessment was a cohort of 19,829 HIV-infected adults.
The researchers found that MI rates were higher for black men and women than white men and women, and for older participants and participants who were not virally suppressed. MI risk was adequately discriminated by the 2013 Pooled Cohort Equations, which predict composite rates of MI and stroke (Harrell C statistic = 0.75). Weak calibration was seen in two data-derived models incorporating HIV-specific covariates in a validation sample, with similar risk discrimination (Harrell C statistic = 0.72 and 0.73 respectively).
“The Pooled Cohort Equations discriminated MI risk and were moderately calibrated in this multicenter HIV cohort,” the authors write. “As HIV-infected cohorts capture and assess MI and stroke outcomes, researchers should revisit the performance of risk estimation tools.”
Several authors disclosed financial ties to the pharmaceutical and medical technology industries.
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