Header

UZH-Logo

Maintenance Infos

A coronary heart disease risk model for predicting the effect of potent antiretroviral therapy in HIV-1 infected men


May, M; Sterne, J A C; Shipley, M; Brunner, E; d'Agostino, R; Whincup, P; Ben-Shlomo, Y; Carr, A; Ledergerber, B; Lundgren, J D; Phillips, A N; Massaro, J; Egger, M (2007). A coronary heart disease risk model for predicting the effect of potent antiretroviral therapy in HIV-1 infected men. International Journal of Epidemiology, 36(6):1309-1318.

Abstract

Background Many HIV-infected patients on highly active antiretroviral therapy (HAART) experience metabolic complications including dyslipidaemia and insulin resistance, which may increase their coronary heart disease (CHD) risk. We developed a prognostic model for CHD tailored to the changes in risk factors observed in patients starting HAART. Methods Data from five cohort studies (British Regional Heart Study, Caerphilly and Speedwell Studies, Framingham Offspring Study, Whitehall II) on 13 100 men aged 40-70 and 114 443 years of follow up were used. CHD was defined as myocardial infarction or death from CHD. Model fit was assessed using the Akaike Information Criterion; generalizability across cohorts was examined using internal-external cross-validation. Results A parametric model based on the Gompertz distribution generalized best. Variables included in the model were systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, triglyceride, glucose, diabetes mellitus, body mass index and smoking status. Compared with patients not on HAART, the estimated CHD hazard ratio (HR) for patients on HAART was 1.46 (95% CI 1.15-1.86) for moderate and 2.48 (95% CI 1.76-3.51) for severe metabolic complications. Conclusions The change in the risk of CHD in HIV-infected men starting HAART can be estimated based on typical changes in risk factors, assuming that HRs estimated using data from non-infected men are applicable to HIV-infected men. Based on this model the risk of CHD is likely to increase, but increases may often be modest, and could be offset by lifestyle changes

Abstract

Background Many HIV-infected patients on highly active antiretroviral therapy (HAART) experience metabolic complications including dyslipidaemia and insulin resistance, which may increase their coronary heart disease (CHD) risk. We developed a prognostic model for CHD tailored to the changes in risk factors observed in patients starting HAART. Methods Data from five cohort studies (British Regional Heart Study, Caerphilly and Speedwell Studies, Framingham Offspring Study, Whitehall II) on 13 100 men aged 40-70 and 114 443 years of follow up were used. CHD was defined as myocardial infarction or death from CHD. Model fit was assessed using the Akaike Information Criterion; generalizability across cohorts was examined using internal-external cross-validation. Results A parametric model based on the Gompertz distribution generalized best. Variables included in the model were systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, triglyceride, glucose, diabetes mellitus, body mass index and smoking status. Compared with patients not on HAART, the estimated CHD hazard ratio (HR) for patients on HAART was 1.46 (95% CI 1.15-1.86) for moderate and 2.48 (95% CI 1.76-3.51) for severe metabolic complications. Conclusions The change in the risk of CHD in HIV-infected men starting HAART can be estimated based on typical changes in risk factors, assuming that HRs estimated using data from non-infected men are applicable to HIV-infected men. Based on this model the risk of CHD is likely to increase, but increases may often be modest, and could be offset by lifestyle changes

Statistics

Citations

Dimensions.ai Metrics
16 citations in Web of Science®
18 citations in Scopus®
Google Scholar™

Altmetrics

Downloads

7 downloads since deposited on 30 Oct 2018
7 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:National licences > 142-005
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:1 December 2007
Deposited On:30 Oct 2018 15:43
Last Modified:01 Nov 2018 08:45
Publisher:Oxford University Press
ISSN:0300-5771
OA Status:Green
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1093/ije/dym135
Related URLs:https://www.swissbib.ch/Search/Results?lookfor=nationallicenceoxford101093ijedym135 (Library Catalogue)
PubMed ID:17652317

Download

Download PDF  'A coronary heart disease risk model for predicting the effect of potent antiretroviral therapy in HIV-1 infected men'.
Preview
Content: Published Version
Language: English
Filetype: PDF (Nationallizenz 142-005)
Size: 121kB
View at publisher