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 Gump 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

Fingerprint

Stroke
HIV
AIDS/HIV
Acquired Immunodeficiency Syndrome
Cohort Studies
HIV-2
HIV-1

ASJC Scopus subject areas

  • Clinical Neurology
  • Arts and Humanities (miscellaneous)

Cite this

Long-term predictive value of the Framingham Risk Score for Stroke in HIV-positive vs HIV-negative men. / Mateen, Farrah J.; Post, Wendy S; Sacktor, Ned; Abraham, Alison Gump; Becker, James T.; Smith, Bryan R.; Detels, Roger; Martin, Eileen; Phair, John P.; Shinohara, Russell T.

In: Neurology, Vol. 81, No. 24, 10.12.2013, p. 2094-2102.

Research output: Contribution to journalArticle

Mateen, Farrah J. ; Post, Wendy S ; Sacktor, Ned ; Abraham, Alison Gump ; Becker, James T. ; Smith, Bryan R. ; Detels, Roger ; Martin, Eileen ; Phair, John P. ; Shinohara, Russell T. / Long-term predictive value of the Framingham Risk Score for Stroke in HIV-positive vs HIV-negative men. In: Neurology. 2013 ; Vol. 81, No. 24. pp. 2094-2102.
@article{6be6841cc46448b2998273bd0d37657d,
title = "Long-term predictive value of the Framingham Risk Score for Stroke in HIV-positive vs HIV-negative men",
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.",
author = "Mateen, {Farrah J.} and Post, {Wendy S} and Ned Sacktor and Abraham, {Alison Gump} and Becker, {James T.} and Smith, {Bryan R.} and Roger Detels and Eileen Martin and Phair, {John P.} and Shinohara, {Russell T.}",
year = "2013",
month = "12",
day = "10",
doi = "10.1212/01.wnl.0000437296.97946.73",
language = "English (US)",
volume = "81",
pages = "2094--2102",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "24",

}

TY - JOUR

T1 - Long-term predictive value of the Framingham Risk Score for Stroke in HIV-positive vs HIV-negative men

AU - Mateen, Farrah J.

AU - Post, Wendy S

AU - Sacktor, Ned

AU - Abraham, Alison Gump

AU - Becker, James T.

AU - Smith, Bryan R.

AU - Detels, Roger

AU - Martin, Eileen

AU - Phair, John P.

AU - Shinohara, Russell T.

PY - 2013/12/10

Y1 - 2013/12/10

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=84892140780&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84892140780&partnerID=8YFLogxK

U2 - 10.1212/01.wnl.0000437296.97946.73

DO - 10.1212/01.wnl.0000437296.97946.73

M3 - Article

C2 - 24212385

AN - SCOPUS:84892140780

VL - 81

SP - 2094

EP - 2102

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 24

ER -