title: Prediction of hard cardiovascular events in HIV patients.
abstract: To assess the accuracy of risk prediction algorithms used in the general population and an HIV-specific algorithm to predict hard cardiovascular events.
  
  
  
  We compared the pooled equation algorithm (PE) proposed by the American Heart Association with the Framingham risk score (FRS) and the HIV-specific DAD (Data Collection on Adverse Effects of Anti-HIV Drugs) algorithm in a cohort of 2550 HIV+ patients followed for 17 337 patient-years.
  
  
  
  During follow-up we recorded 67 myocardial infarctions and 2 cardiovascular deaths. PE and FRS identified and missed the same number of events (44 of 69 identified by PE and 49 of 69 by FRS). Similarly, DAD and FRS predicted and missed the same number of events (38 of 64 and 44 of 64 identified, respectively). All algorithms showed moderate sensitivity, specificity and positive predictive values, but high negative predictive values. However, PE and DAD identified more patients with no events than FRS (13.8% and 9.3% net reclassification improvement, respectively).
  
  
  
  All algorithms showed a modest predictive ability, although the PE and DAD algorithms identified more patients at low risk.
authors: Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB, Canada raggi@ualberta.ca.
authors: Paolo
authors: P
authors: Raggi
authors: UCL Royal Free Campus, HIV Epidemiology & Biostatistics Group Research Department of Infection & Population Health, London, UK.
authors: Davide
authors: D
authors: De Francesco
authors: Cardiology Department, University of Modena and Reggio Emilia, Modena, Italy.
authors: Marcella
authors: M
authors: Manicardi
authors: Metabolic Clinic, Infectious and Tropical Diseases Unit, Department of Medicine, University of Modena and Reggio Emilia, Italy.
authors: Stefano
authors: S
authors: Zona
authors: Ospedale St Anna, Como, Italy.
authors: Antonio
authors: A
authors: Bellasi
authors: Metabolic Clinic, Infectious and Tropical Diseases Unit, Department of Medicine, University of Modena and Reggio Emilia, Italy.
authors: Chiara
authors: C
authors: Stentarelli
authors: Metabolic Clinic, Infectious and Tropical Diseases Unit, Department of Medicine, University of Modena and Reggio Emilia, Italy.
authors: Federica
authors: F
authors: Carli
authors: Metabolic Clinic, Infectious and Tropical Diseases Unit, Department of Medicine, University of Modena and Reggio Emilia, Italy.
authors: Barbara
authors: B
authors: Beghetto
authors: Metabolic Clinic, Infectious and Tropical Diseases Unit, Department of Medicine, University of Modena and Reggio Emilia, Italy.
authors: Cristina
authors: C
authors: Mussini
authors: Metabolic Clinic, Infectious and Tropical Diseases Unit, Department of Medicine, University of Modena and Reggio Emilia, Italy.
authors: Andrea
authors: A
authors: Malagoli
authors: Metabolic Clinic, Infectious and Tropical Diseases Unit, Department of Medicine, University of Modena and Reggio Emilia, Italy.
authors: Giovanni
authors: G
authors: Guaraldi
mesh_terms: D000328:Adult; D000465:Algorithms; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D003661:Decision Support Techniques; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012680:Sensitivity and Specificity