Predicting Risk of Cardiovascular Disease Events (PREVENT) score accuracy among people with HIV in the multicenter CNICS cohort

作者：Matthew S. Durstenfeld, Robin M. Nance, Raymond C. F. Jones, Rebecca Abelman, Alexander P. Hoffmann, Greer Burkholder, Priscilla Y. Hsue, Chris T. Longenecker, Peter W. Hunt, Michael S. Saag, Joseph A. Delaney, Matthew J. Feinstein, Heidi M. Crane · 发表于：AIDS · 年份：2025 · DOI：10.1097/qad.0000000000004331 · 被引用次数：5 · 研究领域：HIV-related health complications and treatments、Diabetes, Cardiovascular Risks, and Lipoproteins、Lipoproteins and Cardiovascular Health

BACKGROUND: People with HIV (PWH) are at elevated cardiovascular risk, but existing calculators have suboptimal calibration for this population. The American Heart Association developed new prediction equations (PREVENT) to replace the pooled cohort equations (PCE). PREVENT has not been validated among PWH. METHODS: Within the Center for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort, we included individuals aged 40-75 without myocardial infarction or stroke at baseline from 2001 to 2021. We calculated predicted 10-year atherosclerotic cardiovascular disease (ASCVD) risk at baseline using the PCE and the PREVENT 10-year ASCVD base equation. Myocardial infarction and stroke were systematically adjudicated. To assess discrimination, we calculated Harrell's C -index and to assess calibration we used the Greenwood-Nam-D'Agostino goodness-of-fit tests. RESULTS: We included 13 135 individuals from five sites across the United States. Mean age at enrollment was 44 ± 9 years and 18% were female. Mean predicted 10-year ASCVD risk was 5.8% by PCE and 2.9% by PREVENT. Over 5.7 ± 3.5 years of follow-up, 628 individuals had myocardial infarction or stroke. Discrimination was improved with PREVENT compared to PCE, with Harrell's C -indexes of 0.722 (95% CI 0.701, 0.741) and 0.708 (95% CI 0.687, 0.729), respectively ( P = 0.008). Both equations underpredicted risk: the observed-to-expected ratio was 2.69 for PREVENT ( P < 0.001) and 1.35 for PCE ( P < 0.001). Calibratio...