Supplemental Figure 1. Comparison of the prevalence of coronary plaque among HIV- infected men in the MACS who were classified as low risk by each of the three CVD algorithms, stratified by age greater than 50 years, 2010-2013.
Two sample differences in proportion was assessed; * p < 0.05, ** p < 0.01, *** p < 0.001
Supplemental Table 1: Comparison of Cardiovascular Disease Risk Score Components Pooled cohort
equation (General population)
Framingham hard CHD risk score (General population)
D:A:D risk score (HIV-infected
population) Predictors
Age X X X
Race *
Systolic blood pressure X X X
Hypertension treatment X X
Total cholesterol X X X
HDL cholesterol X X X
Current smoking X X X
Former smoking X
Diabetes X ** X
HIV-specific Predictors
Indinavir (current use and cumulative years)
X
Lopinavir (current use and cumulative years)
X
Abacavir (current use) X
Risk time horizon 10 year 10 year 5 year
Outcome(s) Predicted atherosclerotic cardiovascular disease
(ASCVD): coronary death, nonfatal
myocardial infarction, coronary death
myocardial infarction (including nonfatal and
fatal cases)
myocardial infarction, fatal/ nonfatal stroke
*Different equation terms and weights are used for black and non-black populations.
**Diabetes was not included in the risk score. All diabetics are categorized as high risk.
Supplemental Table 2: Comparison of the odds of plaque by HIV Serostatus, among men categorized as “low risk” by the Pooled Cohort Equation and FRS
Pooled Cohort Equation Framingham Hard Coronary Events Risk Score
N % OR 95% CI p-value N % OR 95% CI p-value
CAC>0
HIV- Low Risk 117 26.5% 1.0 [ref] 197 36.0% 1.0 [ref]
HIV+ Low Risk 178 36.0% 1.6 [0.9,2.6] 0.09 293 41.6% 1.3 [0.9,1.8] 0.21
Any Plaque on CCTA
HIV- Low Risk 93 52.7% 1.0 [ref] 162 63.6% 1.0 [ref]
HIV+ Low Risk 146 63.0% 1.5 [0.9,2.6] 0.11 237 70.5% 1.4 [0.9,2.1] 0.15
Non Calcified Plaque
HIV- Low Risk 93 40.9% 1.0 [ref] 162 49.4% 1.0 [ref]
HIV+ Low Risk 146 47.3% 1.3 [0.8,2.2] 0.33 237 54.4% 1.2 [0.8,1.8] 0.32
Mixed Plaque
HIV- Low Risk 93 15.1% 1.0 [ref] 162 19.8% 1.0 [ref]
HIV+ Low Risk 146 24.7% 1.8 [0.9,3.7] 0.08 237 27.4% 1.5 [0.9,2.5] 0.08
Stenosis >=50%
HIV- Low Risk 93 5.4% 1.0 [ref] 162 7.4% 1.0 [ref]
HIV+ Low Risk 146 11.6% 2.3 [0.8,6.5] 0.11 237 12.7% 1.8 [0.9,3.7] 0.10
Supplemental Table 3. Association between Framingham Hard CVD Risk Categories and Coronary Plaque by HIV serostatus, among men in the MACS, 2010-2013
HIV-infected (n=445 CTA/n=599 CT)
HIV-uninfected (n=304 CTA/n=375 CT) N % OR and 95%
CI
N % OR and 95% CI
Interaction p-value CAC>0
Low Risk 293 41.6% 1 (ref) 197 36.0% 1 (ref)
Moderate Risk 182 67.0% 2.85***
[1.94,4.20]
121 68.6% 3.88***
[2.39,6.27]
0.33
High Risk 124 57.3% 1.88**
[1.23,2.87]
57 71.9% 4.55***
[2.38,8.68]
0.03
Any Plaque on CCTA
Low Risk 237 70.5% 1 (ref) 162 63.6% 1 (ref)
Moderate Risk 131 87.0% 2.81***
[1.57,5.03]
102 87.3% 3.92***
[2.02,7.62]
0.46
High Risk 77 83.1% 2.06*
[1.07,3.99]
40 87.5% 4.01**
[1.49,10.79]
0.27
Non Calcified Plaque Presence
Low Risk 237 54.4% 1 (ref) 162 49.4% 1 (ref)
Moderate Risk 131 68.7% 1.84**
[1.17,2.88]
102 56.9% 1.35 [0.82,2.22]
0.37
High Risk 77 79.2% 3.19***
[1.74,5.86]
40 57.5% 1.39 [0.69,2.79]
0.08
Mixed Plaque Presence
Low Risk 237 27.4% 1 (ref) 162 19.8% 1 (ref)
Moderate Risk 131 45.0% 2.17***
[1.39,3.39]
102 45.1% 3.34***
[1.93,5.78]
0.23
High Risk 77 35.1% 1.43 [0.83,2.47]
40 47.5% 3.68***
[1.77,7.64]
0.04
Coronary Stenosis >=50%
Low Risk 237 12.7% 1 (ref) 162 7.4% 1 (ref)
Moderate Risk 131 19.8% 1.71 [0.96,3.04]
102 22.5% 3.64***
[1.72,7.70
0.12
High Risk 77 24.7% 2.26* [1.19,4.30]
40 25.0% 4.17**
[1.65,10.52]
0.29
Exponentiated coefficients; 95% confidence intervals in brackets
* p < 0.05, ** p < 0.01, *** p < 0.001
Supplemental Text File 1. Detailed description of Cardiovascular Disease Risk Score calculation.
Both the pooled cohort equation (PCE) and the Framingham Risk Score (FRS) provide a ten-year risk prediction, while the D:A:D score provides a five-year risk prediction. The FRS predicts myocardial infarction (MI) and coronary death and the D:A:D score predicts fatal and nonfatal MI. The PCE has the additional outcomes of fatal and nonfatal stroke as well as
coronary death or nonfatal MI. In addition to the traditional CVD risk factors included in the FRS and PCE, the D:A:D score includes smoking history and HIV-specific variables. Data from semi- annual MACS visits prior to the outcome assessment were used, generally within six months of the CT scans (median 1.9 months , IQR: 0.7, 3.7 months). The risk scores included
combinations of the following variables: age, race (self-report), systolic blood pressure (SBP) (measured), hypertension treatment (self-report), smoking status (self-report), diabetes (fasting glucose ≥ 126 mg/dl or taking diabetes medication at the visit prior to the CT scan or at two or more prior visits), use of indinavir use (current/cumulative), lopinavir (current/cumulative), or abacavir use (current) (self-reported drug data). Total and high-density lipoprotein cholesterol (HDL) were measured from blood samples.