Article

Risk of myocardial infarction associated with chronic hepatitis C virus infection: A population-based cohort study

Division of Gastroenterology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA.
Journal of Viral Hepatitis (Impact Factor: 3.91). 04/2012; 19(4):271-7. DOI: 10.1111/j.1365-2893.2011.01545.x
Source: PubMed

ABSTRACT

Hepatitis C virus (HCV) infection is associated with systemic inflammation and metabolic complications that might predispose patients to atherosclerosis. However, it remains unclear if HCV infection increases the risk of acute myocardial infarction (MI). To determine whether HCV infection is an independent risk factor for acute MI among adults followed in general practices in the United Kingdom (UK), a retrospective cohort study was conducted in The Health Improvement Network, from 1996 through 2008. Patients ≥18 years of age with at least 6 months of follow-up and without a prior history of MI were eligible for study inclusion. HCV-infected individuals, identified with previously validated HCV diagnostic codes (n = 4809), were matched on age, sex and practice with up to 15 randomly selected patients without HCV (n = 71 668). Rates of incident MI among patients with and without a diagnosis of HCV infection were calculated. Adjusted hazard ratios were estimated using Cox proportional hazards regression, controlling for established cardiovascular risk factors. During a median follow-up of 3.2 years, there was no difference in the incidence rates of MI between HCV-infected and -uninfected patients (1.02 vs 0.92 events per 1000 person-years; P = 0.7). HCV infection was not associated with an increased risk of incident MI (adjusted HR, 1.10; 95% confidence interval [CI], 0.67-1.83). Sensitivity analyses including the exploration of a composite outcome of acute MI and coronary interventions yielded similar results (adjusted HR, 1.16; 95% CI, 0.77-1.74). In conclusion, HCV infection was not associated with an increased risk of incident MI.

Download full-text

Full-text

Available from: Andrea B Troxel, Jan 01, 2014
  • Source
    • "The future challenge for hepatologists, in an era in which almost all HCV is eradicable by potent DAAs, will be to determine whether hepatitis C virus-associated metabolic alterations and cardiovascular events are completely reversible or whether some are aggravated after viral clearance by anti-hepatitis C therapy. These discoveries will help to provide personalized care for patients with chronic or past HCV infection.Hypolipidemia Yes[3,110,140141142Hepatic steatosis Yes[140]Obesity No[110]Glucose intolerance, insulin resistance and diabetes No[110,143] Yes145146147148Cardiovascular events No[152]Yes153154155HCV: Hepatitis C virus. "

    Preview · Article · Jan 2016 · World Journal of Gastroenterology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: The mean platelet volume is a parameter routinely determined by complete blood count analyzer, and it is correlates with platelet function and activation. Platelet activation and aggregation play an important role in the pathophysiology of atherosclerosis. The mean platelet volume, which is a marker of platelet activation, is considered as a risk factor for atherothrombosis. Especially in recent years, many studies investigating the relationship between hepatitis C virus and atherosclerosis is noteworthy. The aim of the present study was to investigate mean platelet volume in people with chronic hepatitis C virus infection. Material and Methods: The patient group was constituted by 141 patients followed up due to chronic hepatitis C virus infection, while 107 healthy subjects acted as the control group. The data of patients with chronic hepatitis C virus infection and the control group were analyzed retrospectively. Results: The patients with chronic hepatitis C virus infection had a mean age of 53.5±12, 57 years, there were 57 (40.4%) males and 84 (59.6%) females. In the control group, there were 40 (37.4%) males and 67 (62.6%) females, and mean age was calculated as 53.2±12.8 years. While the platelet count was decreased in subjects with chronic hepatitis C virus infection, the mean platelet volume was increased. Conclusion: It was observed that mean platelet volume levels were not affected by the patient's genotype, RNA and alanine aminotransferase levels. The mean platelet volume was significantly higher in patients with chronic hepatitis C virus infection and this supported other investigations that established a connection between hepatitis C virus infection and the risk of atherothrombosis.
    No preview · Article · Jan 2013 · Turkiye Klinikleri Journal of Medical Sciences
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: Chronic hepatitis C virus (CH-C) infection is associated with metabolic conditions such as insulin resistance and type 2 diabetes (DM) and may increase the risk of cardiovascular diseases. AIM: To assess the association of CH-C with risk factors for cardiovascular diseases using US population data. METHODS: The National Health and Nutrition Examination Surveys (NHANES) collected between 1999 and 2010 were used. RESULTS: A total of 19 741 participants were considered eligible for the study. Of this cohort, 173 individuals (0.88%) had detectable HCV RNA and were considered to have CH-C. Compared with controls, CH-C patients were predominantly African American (23.5% vs. 10.5%, P < 0.0001), men (66.6% vs. 46.1%, P = 0.0001), more likely to be between 45 and 55 years of age (41.9% vs. 20.4%, P = 0.0001), had higher rate of insulin resistance (44.1% vs. 31.1%, P = 0.0301), hypertension (40.1% vs. 28.9%, P = 0.0201), and history of smoking (76.2% vs. 29.9%, P < 0.0001). In multivariate analysis, in addition to known risk factors for insulin resistance, CH-C was independently associated with the presence of insulin resistance [OR (95% CI) = 2.06 (1.19-3.57)], DM [OR = 2.31 (1.18-4.54)] and hypertension [OR = 2.06 (1.30-3.24)]. In addition, independent predictors of cardiovascular diseases included older age, presence of obesity and smoking. Furthermore, CH-C was independently associated with congestive heart failure subtype of cardiovascular diseases but not ischaemic heart disease and stroke. CONCLUSIONS: Chronic hepatitis C virus infection is independently associated with presence of metabolic conditions (insulin resistance, type 2 diabetes and hypertension) and congestive heart failure.
    Preview · Article · Feb 2013 · Alimentary Pharmacology & Therapeutics
Show more