ArticleAIDS (London, England)2025
Predicting Risk of Cardiovascular Disease Events (PREVENT) score accuracy among people with HIV in the multicenter CNICS cohort.
Article in AIDS (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Developing machine learning models to improve cardiovascular risk prediction for people living with HIV.International journal of cardiology. Cardiovascular risk and prevention · 2026Article
- Predictive Value of the Intermountain Mortality Risk Score for Saphenous Vein Graft Degeneration: A Retrospective Cohort Analysis.Medeniyet medical journal · 2026Article
- REPRIEVE Analysis of New Cardiovascular Risk Calculators in HIV: Underpredicting Risk Means Preventing Fewer Heart Attacks.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
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14 authors.
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Abstract
backgroundPeople 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.
methodsWithin 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.
resultsWe 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). Calibration slopes were 1.998 for PREVENT and 0.932 for PCE, respectively.
conclusionsAmong this cohort of PWH, the PREVENT 10-year ASCVD equations were poorly calibrated and underestimated composite risk for myocardial infarction and stroke, with observed risks more than double predicted risks.
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