Abstract Details

Title Insufficiency of the Framingham Risk Score for Stroke Prediction in HIV-Infected Men: Long Term Follow Up in the Multi-Center AIDS Cohort Study (MACS)

Topic Infections/AIDS/Prion Disease

Presentation(s) S38 - (-)

Poster/Presentation
Number 005

Objective

Background The FRS for Stroke includes assessment of baseline vascular risk factors to predict the long term risk of stroke. The score was developed in an HIV-uninfected population and has not been tested for predictive accuracy in HIV+ men.

Design/Methods The Multi-Center AIDS Cohort Study is an ongoing, prospective study of HIV+ and HIV- men who have sex with men (MSM) in 4 U.S. cities. We ascertained all reported stroke events during a recent 15-year timeframe during the HAART era (July 1, 1996-June 30, 2011). Framingham predictive scores were calculated 10 years prior to stroke events. HIV+ and HIV- participants with strokes were compared for FRS points and predicted 10-year stroke risk.

Results There were 3945 participants (1776 HIV+, 2083 HIV-) in MACS during the study timeframe, including 57 HIV+ and 37 HIV- participants with strokes. The predicted baseline risk of stroke within 10-years was higher among HIV- men compared to HIV+ men with strokes (mean 5.9% vs. 2.5% risk, p=0.029). In the entire cohort of HIV+ men who did not experience a stroke (median age at first visit during the HAART era 41 years), the median 10-year predicted risk of stroke was 4% (range 0-15%). In HIV- men, (median age 43), it was 4% (0-22%).

Conclusions FRS Prediction for Stroke was systematically different in HIV+ vs. HIV- men with stroke events, suggesting an insufficiency in the predictive value of the FRS for HIV+ men. Corrective measures, including points for HIV status, should be considered to modify the FRS for Stroke to inform the large number of HAART-treated individuals at long term risk of stroke events.

Authors/Disclosures
Farrah J. Mateen, MD, PhD, FAAN (Massachusetts General Hospital) PRESENTER	Dr. Mateen has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon Therapeutics (Amgen). Dr. Mateen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Mateen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Mateen has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology. The institution of Dr. Mateen has received research support from Genentech. The institution of Dr. Mateen has received research support from EMD Serono. The institution of Dr. Mateen has received research support from Novartis. The institution of Dr. Mateen has received research support from Horizon Therapeutics (Amgen). The institution of Dr. Mateen has received research support from TG Therapeutics. Dr. Mateen has received intellectual property interests from a discovery or technology relating to health care.
	No disclosure on file
Ned C. Sacktor, MD, FAAN	No disclosure on file
	No disclosure on file
Bryan Smith, MD (NIH)	Dr. Smith has nothing to disclose.
James T. Becker, PhD (University of Pittsburgh)	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file

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