CROI 2016 Abstract eBook

Abstract Listing

Poster Abstracts

CV events. CV events were compared between HIV-infected individuals with plaque and matched uninfected controls with plaque and HIV infected individuals with plaque were found to be at higher risk (P=0.03, Figure). Conclusions: HIV-infected individuals without known CV disease have increased prevalence of carotid plaque and NCP, and both are associated with an increased risk of subsequent CV events.

641 Atherosclerotic Myocardial Infarction Risk in the NA-ACCORD Compared to MESA and ARIC

Daniel Drozd 1 ; Heidi M. Crane 1 ; Susan Heckbert 1 ; Matthew Budoff 2 ; Amy C. Justice 3 ; Frank J. Palella 4 ; Daniel B. Klein 5 ; Mari M. Kitahata 1 ; Stephen J. Gange 6 ; Richard Moore 7 1 Univ of Washington, Seattle, WA, USA; 2 Harbor-Univ of California Los Angeles Med Cntr, Torrance, CA, USA; 3 Yale Univ, New Haven, CT, USA; 4 Northwestern Univ, Chicago, IL, USA; 5 Kaiser Permanente San Leandro Med Cntr, San Leandro, CA, USA; 6 Johns Hopkins Bloomberg Sch of PH, Baltimore, MD, USA; 7 Johns Hopkins Univ, Baltimore, MD, USA Background: HIV-infected individuals are likely at increased risk of myocardial infarction (MI) compared to uninfected individuals. However, identifying a comparable uninfected group is difficult because of differences in cardiovascular disease (CVD) risk factors. The Multi-Ethnic Study of Atherosclerosis (MESA) and the Atherosclerosis Risk in Communities (ARIC) are large, diverse general population cohorts designed to assess CVD risk. We report updated results regarding incidence of atherosclerotic (type 1) MI in the NA-ACCORD through 2013 and a comparison of rates from the NA-ACCORD to MESA and ARIC. Methods: Centrally adjudicated incident type 1 MIs from 7 NA-ACCORD clinical cohorts between 1996-2013 contributed to this analysis. We excluded type 2 MIs from the NA- ACCORD analysis in order to focus on atherosclerotic events and because of the low frequency of type 2 events in the general population. MESA events occurred between 2000-2008 and ARIC events from 1987-2010. Incidence rates (IRs) per 1,000 person-years (PY), adjusted rate ratios (aIRRs) and 95% confidence intervals ([,]) were estimated using Poisson regression models; rate ratios were adjusted for age, sex, race, and smoking. Results: 29,212 HIV-infected NA-ACCORD participants contributed 338 type 1 MI events and 131,802 PYs. MESA and ARIC participants contributed 156 and 1,448 events, and 47,713 and 281,284 PYs, respectively. NA-ACCORD participants were younger and more likely to be of black race and male than MESA and ARIC participants. Rates of MI were significantly higher in NA-ACCORD compared to MESA and ARIC (Table 1). As expected increased age, male sex, race, and smoking were all significantly associated with MI independent of HIV infection status. Conclusions: We found MI rates were higher in NA-ACCORD compared to two large CVD cohorts of presumably HIV-uninfected adults after controlling for demographic risk factors and smoking. While prevalent MIs were excluded from all cohorts, MESA more stringently excluded individuals with any baseline CVD risk factors. As a result, the magnitude of the increased risk varied between MESA and ARIC highlighting the importance of selecting an appropriate uninfected control group. A limitation of our study was the lack of controlling for other important CVD risk factors including hypertension and hyperlipidemia. Future analysis will focus on examining changes in MI incidence over calendar time and adjusting for additional traditional CVD risk factors.

Poster Abstracts

642 Cardiovascular Disease Risk Model Comparison and Development in HIV-Infected Veterans

Meredith E. Clement 1 ; Lawrence Park 1 ; Ann Marie Navar 1 ; N. L. Okeke 1 ; Michael J. Pencina 2 ; Pamela Douglas 1 ; Susanna Naggie 3 1 Duke Univ Med Cntr, Durham, NC, USA; 2 Duke Clinical Rsr Inst, Durham, NC, USA; 3 Duke Univ Sch of Med, Durham, NC, USA Background: Persons infected with HIV have a higher risk of cardiovascular disease (CVD) after adjustment for traditional risk factors. Despite this increased risk, HIV is not accounted for in traditional CVD risk calculations or cholesterol guidelines. Methods: We assessed 10-year CVD events in veterans infected with HIV using the Veterans Affairs (VA) Clinical Case Registry (CCR) from 2001-2010. Baseline (1998-2000) laboratory, comorbidity, and medication data were used to determine patient risk scores according to both the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) model

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CROI 2016