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

*Corresponding author for this work

Research output: Contribution to journalArticle

30 Scopus citations

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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    Mateen, F. J., Post, W. S., Sacktor, N., Abraham, A. G., Becker, J. T., Smith, B. R., Detels, R., Martin, E., Phair, J. P., & Shinohara, R. T. (2013). Long-term predictive value of the Framingham Risk Score for Stroke in HIV-positive vs HIV-negative men. Neurology, 81(24), 2094-2102. https://doi.org/10.1212/01.wnl.0000437296.97946.73