Performance of the Pooled Cohort atherosclerotic cardiovascular disease risk score in hepatitis C virus‐infected persons
Summary Chronic hepatitis C virus (HCV) infection has been associated with an increased risk for cardiovascular disease (CVD). The recommended Pooled Cohort atherosclerotic cardiovascular disease (ASCVD) risk equation for estimation of 10‐year CVD risk has not been validated in HCV‐infected populati...
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| Veröffentlicht in: | Journal of viral hepatitis 2017-10, Vol.24 (10), p.814-822 |
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| container_title | Journal of viral hepatitis |
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| creator | Chew, K. W. Bhattacharya, D. Horwich, T. B. Yan, P. McGinnis, K. A. Tseng, C. Freiberg, M. S. Currier, J. S. Butt, A. A. |
| description | Summary
Chronic hepatitis C virus (HCV) infection has been associated with an increased risk for cardiovascular disease (CVD). The recommended Pooled Cohort atherosclerotic cardiovascular disease (ASCVD) risk equation for estimation of 10‐year CVD risk has not been validated in HCV‐infected populations. We examined the performance of the ASCVD risk score in HCV‐infected persons, using the national Electronically Retrieved Cohort of HCV Infected Veterans to derive a cohort of HCV‐infected and uninfected subjects without baseline ASCVD, hepatitis B, or HIV infection, and with low‐density lipoprotein cholesterol level |
| doi_str_mv | 10.1111/jvh.12705 |
| format | Article |
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Chronic hepatitis C virus (HCV) infection has been associated with an increased risk for cardiovascular disease (CVD). The recommended Pooled Cohort atherosclerotic cardiovascular disease (ASCVD) risk equation for estimation of 10‐year CVD risk has not been validated in HCV‐infected populations. We examined the performance of the ASCVD risk score in HCV‐infected persons, using the national Electronically Retrieved Cohort of HCV Infected Veterans to derive a cohort of HCV‐infected and uninfected subjects without baseline ASCVD, hepatitis B, or HIV infection, and with low‐density lipoprotein cholesterol level<190 mg/dL. Performance of the ASCVD risk equation was assessed by Cox proportional hazard regression, C‐statistics and Hosmer‐Lemeshow statistic. The cohort included 70 490 HCV‐infected and 97 766 HCV‐uninfected men with mean age of 55 years, 56% White and 29% Black. Incident CVD event rates were similar between the two groups (13.2 and 13.4 events/1000 person‐years), with a higher incidence of coronary heart disease events in the HCV‐uninfected group and of stroke events in the HCV‐infected group. Adjusting for ASCVD risk score, HCV infection was associated with higher risk for an ASCVD event in the subgroup with baseline ASCVD risk ≥7.5% (HR: 1.19, P<.0001). C‐statistics were poor in both the HCV‐infected and uninfected groups (0.60 and 0.61, respectively). By Hosmer‐Lemeshow test, the ASCVD risk equation overestimated risk amongst lower risk patients and underestimated risk amongst higher risk patients in both the HCV‐infected and uninfected groups. Further investigation is needed to determine whether a modified equation to accurately predict ASCVD risk in HCV‐infected persons is warranted.</description><identifier>ISSN: 1352-0504</identifier><identifier>EISSN: 1365-2893</identifier><identifier>DOI: 10.1111/jvh.12705</identifier><identifier>PMID: 28273386</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Aged ; Arteriosclerosis ; Atherosclerosis ; Atherosclerosis - epidemiology ; Atherosclerosis - etiology ; atherosclerotic cardiovascular disease score ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - etiology ; cardiovascular risk assessment ; Cholesterol ; Chronic infection ; Comorbidity ; Coronary artery disease ; Female ; Health risk assessment ; Heart diseases ; Hepacivirus ; Hepatitis ; Hepatitis B ; Hepatitis C ; Hepatitis C - complications ; Hepatitis C - virology ; hepatitis C virus ; Humans ; Incidence ; Infections ; Low density lipoprotein ; Male ; Middle Aged ; Population Surveillance ; Proportional Hazards Models ; Reproducibility of Results ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Statistics ; Stroke</subject><ispartof>Journal of viral hepatitis, 2017-10, Vol.24 (10), p.814-822</ispartof><rights>2017 John Wiley & Sons Ltd</rights><rights>2017 John Wiley & Sons Ltd.</rights><rights>Copyright © 2017 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4435-9aaf660a538b2d98aa225d616c0ba4dab73e2b77adc0477940153094c02b871e3</citedby><cites>FETCH-LOGICAL-c4435-9aaf660a538b2d98aa225d616c0ba4dab73e2b77adc0477940153094c02b871e3</cites><orcidid>0000-0003-4865-4348</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjvh.12705$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjvh.12705$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,777,781,882,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28273386$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chew, K. W.</creatorcontrib><creatorcontrib>Bhattacharya, D.</creatorcontrib><creatorcontrib>Horwich, T. B.</creatorcontrib><creatorcontrib>Yan, P.</creatorcontrib><creatorcontrib>McGinnis, K. A.</creatorcontrib><creatorcontrib>Tseng, C.</creatorcontrib><creatorcontrib>Freiberg, M. S.</creatorcontrib><creatorcontrib>Currier, J. S.</creatorcontrib><creatorcontrib>Butt, A. A.</creatorcontrib><title>Performance of the Pooled Cohort atherosclerotic cardiovascular disease risk score in hepatitis C virus‐infected persons</title><title>Journal of viral hepatitis</title><addtitle>J Viral Hepat</addtitle><description>Summary
Chronic hepatitis C virus (HCV) infection has been associated with an increased risk for cardiovascular disease (CVD). The recommended Pooled Cohort atherosclerotic cardiovascular disease (ASCVD) risk equation for estimation of 10‐year CVD risk has not been validated in HCV‐infected populations. We examined the performance of the ASCVD risk score in HCV‐infected persons, using the national Electronically Retrieved Cohort of HCV Infected Veterans to derive a cohort of HCV‐infected and uninfected subjects without baseline ASCVD, hepatitis B, or HIV infection, and with low‐density lipoprotein cholesterol level<190 mg/dL. Performance of the ASCVD risk equation was assessed by Cox proportional hazard regression, C‐statistics and Hosmer‐Lemeshow statistic. The cohort included 70 490 HCV‐infected and 97 766 HCV‐uninfected men with mean age of 55 years, 56% White and 29% Black. Incident CVD event rates were similar between the two groups (13.2 and 13.4 events/1000 person‐years), with a higher incidence of coronary heart disease events in the HCV‐uninfected group and of stroke events in the HCV‐infected group. Adjusting for ASCVD risk score, HCV infection was associated with higher risk for an ASCVD event in the subgroup with baseline ASCVD risk ≥7.5% (HR: 1.19, P<.0001). C‐statistics were poor in both the HCV‐infected and uninfected groups (0.60 and 0.61, respectively). By Hosmer‐Lemeshow test, the ASCVD risk equation overestimated risk amongst lower risk patients and underestimated risk amongst higher risk patients in both the HCV‐infected and uninfected groups. Further investigation is needed to determine whether a modified equation to accurately predict ASCVD risk in HCV‐infected persons is warranted.</description><subject>Aged</subject><subject>Arteriosclerosis</subject><subject>Atherosclerosis</subject><subject>Atherosclerosis - epidemiology</subject><subject>Atherosclerosis - etiology</subject><subject>atherosclerotic cardiovascular disease score</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - etiology</subject><subject>cardiovascular risk assessment</subject><subject>Cholesterol</subject><subject>Chronic infection</subject><subject>Comorbidity</subject><subject>Coronary artery disease</subject><subject>Female</subject><subject>Health risk assessment</subject><subject>Heart diseases</subject><subject>Hepacivirus</subject><subject>Hepatitis</subject><subject>Hepatitis B</subject><subject>Hepatitis C</subject><subject>Hepatitis C - complications</subject><subject>Hepatitis C - virology</subject><subject>hepatitis C virus</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infections</subject><subject>Low density lipoprotein</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Population Surveillance</subject><subject>Proportional Hazards Models</subject><subject>Reproducibility of Results</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Statistics</subject><subject>Stroke</subject><issn>1352-0504</issn><issn>1365-2893</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1u1DAURq0KREvLoi-ALLGBRVr_xLGzQUIjoKBK7aKwtW6cG-IhEw92MqiseASekSfBw5SqVKoXtmUfHX32R8gxZyc8j9Plpj_hQjO1Rw64rFQhTC0fbfdKFEyxcp88TWnJGJdC8SdkXxihpTTVAflxibELcQWjQxo6OvVIL0MYsKWL0Ic4UchHMSQ35HnyjjqIrQ8bSG4eINLWJ4SENPr0lSYXIlI_0h7XMPnJJ7qgGx_n9PvnLz926KYsXmNMYUxH5HEHQ8JnN-sh-fTu7dXirDi_eP9h8ea8cGUpVVEDdFXFQEnTiLY2AEKotuKVYw2ULTRaomi0htaxUuu6ZFxJVpeOicZojvKQvN5513OzwtbhOEUY7Dr6FcRrG8Db_29G39svYWOVMnWp6yx4eSOI4duMabIrnxwOA4wY5mS5MZXM8ZjK6It76DLMcczPs7yWlVCCqS31ake5_LEpYncbhjO7bdTmRu3fRjP7_G76W_JfhRk43QHf_YDXD5vsx89nO-UfOwWuMQ</recordid><startdate>201710</startdate><enddate>201710</enddate><creator>Chew, K. W.</creator><creator>Bhattacharya, D.</creator><creator>Horwich, T. B.</creator><creator>Yan, P.</creator><creator>McGinnis, K. A.</creator><creator>Tseng, C.</creator><creator>Freiberg, M. S.</creator><creator>Currier, J. S.</creator><creator>Butt, A. A.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-4865-4348</orcidid></search><sort><creationdate>201710</creationdate><title>Performance of the Pooled Cohort atherosclerotic cardiovascular disease risk score in hepatitis C virus‐infected persons</title><author>Chew, K. W. ; Bhattacharya, D. ; Horwich, T. B. ; Yan, P. ; McGinnis, K. A. ; Tseng, C. ; Freiberg, M. S. ; Currier, J. S. ; Butt, A. A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4435-9aaf660a538b2d98aa225d616c0ba4dab73e2b77adc0477940153094c02b871e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Arteriosclerosis</topic><topic>Atherosclerosis</topic><topic>Atherosclerosis - epidemiology</topic><topic>Atherosclerosis - etiology</topic><topic>atherosclerotic cardiovascular disease score</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Cardiovascular Diseases - etiology</topic><topic>cardiovascular risk assessment</topic><topic>Cholesterol</topic><topic>Chronic infection</topic><topic>Comorbidity</topic><topic>Coronary artery disease</topic><topic>Female</topic><topic>Health risk assessment</topic><topic>Heart diseases</topic><topic>Hepacivirus</topic><topic>Hepatitis</topic><topic>Hepatitis B</topic><topic>Hepatitis C</topic><topic>Hepatitis C - complications</topic><topic>Hepatitis C - virology</topic><topic>hepatitis C virus</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infections</topic><topic>Low density lipoprotein</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Population Surveillance</topic><topic>Proportional Hazards Models</topic><topic>Reproducibility of Results</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Statistics</topic><topic>Stroke</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chew, K. W.</creatorcontrib><creatorcontrib>Bhattacharya, D.</creatorcontrib><creatorcontrib>Horwich, T. B.</creatorcontrib><creatorcontrib>Yan, P.</creatorcontrib><creatorcontrib>McGinnis, K. A.</creatorcontrib><creatorcontrib>Tseng, C.</creatorcontrib><creatorcontrib>Freiberg, M. S.</creatorcontrib><creatorcontrib>Currier, J. S.</creatorcontrib><creatorcontrib>Butt, A. A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of viral hepatitis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chew, K. W.</au><au>Bhattacharya, D.</au><au>Horwich, T. B.</au><au>Yan, P.</au><au>McGinnis, K. A.</au><au>Tseng, C.</au><au>Freiberg, M. S.</au><au>Currier, J. S.</au><au>Butt, A. A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Performance of the Pooled Cohort atherosclerotic cardiovascular disease risk score in hepatitis C virus‐infected persons</atitle><jtitle>Journal of viral hepatitis</jtitle><addtitle>J Viral Hepat</addtitle><date>2017-10</date><risdate>2017</risdate><volume>24</volume><issue>10</issue><spage>814</spage><epage>822</epage><pages>814-822</pages><issn>1352-0504</issn><eissn>1365-2893</eissn><abstract>Summary
Chronic hepatitis C virus (HCV) infection has been associated with an increased risk for cardiovascular disease (CVD). The recommended Pooled Cohort atherosclerotic cardiovascular disease (ASCVD) risk equation for estimation of 10‐year CVD risk has not been validated in HCV‐infected populations. We examined the performance of the ASCVD risk score in HCV‐infected persons, using the national Electronically Retrieved Cohort of HCV Infected Veterans to derive a cohort of HCV‐infected and uninfected subjects without baseline ASCVD, hepatitis B, or HIV infection, and with low‐density lipoprotein cholesterol level<190 mg/dL. Performance of the ASCVD risk equation was assessed by Cox proportional hazard regression, C‐statistics and Hosmer‐Lemeshow statistic. The cohort included 70 490 HCV‐infected and 97 766 HCV‐uninfected men with mean age of 55 years, 56% White and 29% Black. Incident CVD event rates were similar between the two groups (13.2 and 13.4 events/1000 person‐years), with a higher incidence of coronary heart disease events in the HCV‐uninfected group and of stroke events in the HCV‐infected group. Adjusting for ASCVD risk score, HCV infection was associated with higher risk for an ASCVD event in the subgroup with baseline ASCVD risk ≥7.5% (HR: 1.19, P<.0001). C‐statistics were poor in both the HCV‐infected and uninfected groups (0.60 and 0.61, respectively). By Hosmer‐Lemeshow test, the ASCVD risk equation overestimated risk amongst lower risk patients and underestimated risk amongst higher risk patients in both the HCV‐infected and uninfected groups. Further investigation is needed to determine whether a modified equation to accurately predict ASCVD risk in HCV‐infected persons is warranted.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28273386</pmid><doi>10.1111/jvh.12705</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-4865-4348</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Arteriosclerosis Atherosclerosis Atherosclerosis - epidemiology Atherosclerosis - etiology atherosclerotic cardiovascular disease score Cardiovascular disease Cardiovascular diseases Cardiovascular Diseases - epidemiology Cardiovascular Diseases - etiology cardiovascular risk assessment Cholesterol Chronic infection Comorbidity Coronary artery disease Female Health risk assessment Heart diseases Hepacivirus Hepatitis Hepatitis B Hepatitis C Hepatitis C - complications Hepatitis C - virology hepatitis C virus Humans Incidence Infections Low density lipoprotein Male Middle Aged Population Surveillance Proportional Hazards Models Reproducibility of Results Retrospective Studies Risk Assessment Risk Factors Statistics Stroke |
| title | Performance of the Pooled Cohort atherosclerotic cardiovascular disease risk score in hepatitis C virus‐infected persons |
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