Hepatitis C Linked To Higher Risk of Coronary Artery Disease

MedicalResearch.com Interview with:
Naga Pothineni, MD
Division of Cardiology
University of Arkansas for Medical Science

MedicalResearch: What are the main findings of the study?

Dr. Pothineni: Hepatitis C is a blood borne infection that is very common worldwide. Most pateints who contract hepatitis C develop a chronic form on infection that progresses to liver damage and eventually hepatocellular cancer. Coronary heart disease is a worldwide problem as well. There has been interest in chronic infections being a mechanism of progression of atherosclerosis and coronary heart disease. We wanted to study the association of coronary heart disease events in patients with hepatitis C. We conducted a retrospective study of around 24,000 patients of which around 10,000 were hepatitis C positive. Our study showed that patients who have hepatitis C have a higher incidence of coronary heart disease events (myocardial infarction) when compared to patients who are negative for hepatitis C. In our analysis, we found that hepatitis C positivity is an independent risk factor for coronary events after adjusting for traditional cardiovascular risk factors like age, hypertension, smoking and diabetes.

Another interesting finding in our study was that patients with hepatitis C have lower levels of cholesterol compared to patients without hepatitis C. Low cholesterol levels in these patients do not seem to be protective against future coronary heart disease events.


MedicalResearch: What was most surprising about the results?

Dr. Pothineni: A novel and surprising result in our study was that patients with persistent (active) hepatitis C infection have  higher incidence of coronary heart disease events compared to patients who have remote or treated infection.

Some patients who have hepatitis C spontaneously clear their infection by the natural immune responses. Those that fail to do so appear to be at a higher cardiovascular risk

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Pothineni: Clinicians should be aware of hepatitis C being a potential cardiac risk factor. Active infection can be detected by checking for hepatitis C RNA levels. It might be reasonable to aggressively control traditional cardiovascular risk factors in patients with active infection to decrease the incidence of coronary heart disease events in this population

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Pothineni: Treatment for hepatitis C has advanced tremendously and it is now possible to achieve cure. Future research can show us if treatment of hepatitis C with the currently available therapies can help decrease cardiovascular risk in these patients.

Citation:

Impact of Hepatitis C Seropositivity on the Risk of Coronary Heart Disease Events Pothineni, Naga Venkata et al. American Journal of Cardiology

 

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