Long-term predictive value of the Framingham Risk Score for Stroke in HIV-positive vs HIV-negative men

Farrah J. Mateen, Wendy S. Post, Ned Sacktor, Alison G. Abraham, James T. Becker, Bryan R. Smith, Roger Detels, Eileen Martin, John P. Phair, Russell T. Shinohara

Research output: Contribution to journalArticle

Abstract

Objective: To test the predictive accuracy of the Framingham Risk Score for Stroke (FRS-S) in HIV-infected (HIV+) vs HIV-uninfected (HIV-) men. Methods: The Multicenter AIDS Cohort Study (MACS) is an ongoing prospective study of HIV+ and HIV-men who have sex with men (MSM) enrolled in 4 US cities. We ascertained all reported stroke events during a recent 15-year timeframe (July 1, 1996 to June 30, 2011) among 3,945 participants (1,776 HIV+ and 2,169 HIV-). For those with strokes, FRS-S were calculated 10 years before the stroke event and assessed according to HIV status. Results: A total of 114 stroke events occurred, including 57 HIV+ and 37 HIV-participants with first-ever strokes and 19 fatal strokes. The incidence of first-ever stroke was 1.7/1,000 personyears among HIV- and 3.3/1,000 person-years among HIV+ participants. Among those with strokes, HIV+participants were younger than HIV-participants (median age 51.3 vs 61.8 years, < 0.0001). For these men with stroke, the average 10-year risk of stroke was higher for HIV-MSM (6.6% [range 3%-26%] vs 4.9% for HIV+ MSM [range 0%-15%], < 0.04). Traditional risk factors for stroke were similar among the Framingham cohort and the MACS HIV+ and HIV-participants. Conclusions: FRS-S prediction was systematically different in HIV+ vs HIV-men with stroke events. The FRS-S underestimates the long-term risk of stroke in HIV+ men.

Original languageEnglish (US)
Pages (from-to)2094-2102
Number of pages9
JournalNeurology
Volume81
Issue number24
DOIs
StatePublished - Dec 10 2013

ASJC Scopus subject areas

  • Clinical Neurology

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