Adeel A Butt1,2,3, Peng Yan1, Kara W Chew4, Judith Currier4, Kathleen Corey5, Raymond T Chung5, Ashfaq Shuaib2, Abdul-Badi Abou-Samra2, Javed Butler6, Matthew S Freiberg7. 1. VA Pittsburgh Healthcare System, Pennsylvania. 2. Hamad Healthcare Quality Institute, Hamad Medical Corporation, Doha, Qatar. 3. Weill Cornell Medical College, Doha, Qatar and New York, New York. 4. David Geffen School of Medicine at University of California, Los Angeles. 5. Massachusetts General Hospital and Harvard Medical School, Boston. 6. State University of New York at Stony Brook. 7. Vanderbilt University, Nashville, Tennessee.
Abstract
BACKGROUND: Risk of acute myocardial infarction (AMI) among hepatitis C virus (HCV)-positive versus HCV-negative persons with similar lipid levels is unknown. We determined incident AMI rates among HCV-positive and HCV-negative men among various lipid strata. METHODS: We created a propensity score matched (PSM) cohort and a low cardiovascular disease (CVD) risk cohort. Primary outcome was incident AMI rates by HCV status in each lipid strata using National Cholesterol Program guidelines for lipid strata. RESULTS: We identified 85863 HCV-positive and HCV-negative men in the PSM population. The incidence rates/1000 patient-years (95% confidence interval [CI]) for AMI among total cholesterol (TC) 200-239 stratum were 5.3 (4.89, 5.71) for HCV-positive versus 4.71 (4.42, 5) for HCV-negative men (P = .02) and for TC >240 mg/dL were 7.38 (6.49, 8.26) versus 6.17 (5.64, 6.71) (P = .02). For low-density lipoprotein cholesterol (LDL) of 130-159 mg/dL, AMI rates were 5.44 (4.97, 5.91) for HCV-positive and 4.81 (4.48, 5.14) for HCV-negative men (P = .03). The rise in risk with increasing lipid levels was greater in younger HCV-positive than in HCV-negative men (e.g., TC > 240 mg/dL: age >50 HR 1.38 [HCV-positive] and 1.12 [HCV-negative]; age ≤50 HR 1.6 [HCV-positive] and 1.29 [HCV-negative]), and more profoundly altered in HCV-positive men by lipid lowering therapy (change in HR with lipid-lowering therapy for TC >240 mg/dL from 1.82 to 1.19 [HCV-positive] from 1.48 to 1.03 [HCV-negative]). CONCLUSIONS: HCV-positive men have a higher risk of AMI than HCV-negative men at higher TC/LDL levels; this risk is more pronounced at a younger age. Lipid lowering therapy significantly reduces this risk, with more profound reduction among HCV-positive versus HCV-negative men at similar lipid levels.
BACKGROUND: Risk of acute myocardial infarction (AMI) among hepatitis C virus (HCV)-positive versus HCV-negative persons with similar lipid levels is unknown. We determined incident AMI rates among HCV-positive and HCV-negative men among various lipid strata. METHODS: We created a propensity score matched (PSM) cohort and a low cardiovascular disease (CVD) risk cohort. Primary outcome was incident AMI rates by HCV status in each lipid strata using National Cholesterol Program guidelines for lipid strata. RESULTS: We identified 85863 HCV-positive and HCV-negative men in the PSM population. The incidence rates/1000 patient-years (95% confidence interval [CI]) for AMI among total cholesterol (TC) 200-239 stratum were 5.3 (4.89, 5.71) for HCV-positive versus 4.71 (4.42, 5) for HCV-negative men (P = .02) and for TC >240 mg/dL were 7.38 (6.49, 8.26) versus 6.17 (5.64, 6.71) (P = .02). For low-density lipoprotein cholesterol (LDL) of 130-159 mg/dL, AMI rates were 5.44 (4.97, 5.91) for HCV-positive and 4.81 (4.48, 5.14) for HCV-negative men (P = .03). The rise in risk with increasing lipid levels was greater in younger HCV-positive than in HCV-negative men (e.g., TC > 240 mg/dL: age >50 HR 1.38 [HCV-positive] and 1.12 [HCV-negative]; age ≤50 HR 1.6 [HCV-positive] and 1.29 [HCV-negative]), and more profoundly altered in HCV-positive men by lipid lowering therapy (change in HR with lipid-lowering therapy for TC >240 mg/dL from 1.82 to 1.19 [HCV-positive] from 1.48 to 1.03 [HCV-negative]). CONCLUSIONS: HCV-positive men have a higher risk of AMI than HCV-negative men at higher TC/LDL levels; this risk is more pronounced at a younger age. Lipid lowering therapy significantly reduces this risk, with more profound reduction among HCV-positive versus HCV-negative men at similar lipid levels.
Authors: Sanjaya K Satapathy; Yun Ju Kim; Ashish Kataria; Arash Shifteh; Rohan Bhansali; Maurice A Cerulli; David Bernstein Journal: J Clin Exp Hepatol Date: 2013-06-11
Authors: Matthew S Freiberg; Chung-Chou H Chang; Melissa Skanderson; Kathleen McGinnis; Lewis H Kuller; Kevin L Kraemer; David Rimland; Matthew B Goetz; Adeel A Butt; Maria C Rodriguez Barradas; Cynthia Gibert; David Leaf; Sheldon T Brown; Jeffrey Samet; Lewis Kazis; Kendall Bryant; Amy C Justice Journal: Circ Cardiovasc Qual Outcomes Date: 2011-06-28
Authors: Maria Boddi; Rosanna Abbate; Benedetta Chellini; Betti Giusti; Carlo Giannini; Giovanni Pratesi; Luciana Rossi; Carlo Pratesi; Gian Franco Gensini; Laura Paperetti; Anna Linda Zignego Journal: J Clin Virol Date: 2009-11-05 Impact factor: 3.168
Authors: Adeel A Butt; Wang Xiaoqiang; Matthew Budoff; David Leaf; Lewis H Kuller; Amy C Justice Journal: Clin Infect Dis Date: 2009-07-15 Impact factor: 9.079
Authors: Jessica Williams-Nguyen; Stephen E Hawes; Robin M Nance; Sara Lindström; Susan R Heckbert; H Nina Kim; W Chris Mathews; Edward R Cachay; Matt Budoff; Christopher B Hurt; Peter W Hunt; Elvin Geng; Richard D Moore; Michael J Mugavero; Inga Peter; Mari M Kitahata; Michael S Saag; Heidi M Crane; Joseph A Delaney Journal: Am J Epidemiol Date: 2020-06-01 Impact factor: 4.897
Authors: Lova Sun; Ravi B Parikh; Rebecca A Hubbard; John Cashy; Samuel U Takvorian; David J Vaughn; Kyle W Robinson; Vivek Narayan; Bonnie Ky Journal: JAMA Netw Open Date: 2021-02-01
Authors: Paweł Rajewski; Dorota Zarębska-Michaluk; Ewa Janczewska; Andrzej Gietka; Włodzimierz Mazur; Magdalena Tudrujek-Zdunek; Krzysztof Tomasiewicz; Teresa Belica-Wdowik; Barbara Baka-Ćwierz; Dorota Dybowska; Waldemar Halota; Beata Lorenc; Marek Sitko; Aleksander Garlicki; Hanna Berak; Andrzej Horban; Iwona Orłowska; Krzysztof Simon; Łukasz Socha; Marta Wawrzynowicz-Syczewska; Jerzy Jaroszewicz; Zbigniew Deroń; Agnieszka Czauż-Andrzejuk; Jolanta Citko; Rafał Krygier; Anna Piekarska; Łukasz Laurans; Witold Dobracki; Jolanta Białkowska; Olga Tronina; Magdalena Wietlicka-Piszcz; Małgorzata Pawłowska; Robert Flisiak Journal: J Clin Med Date: 2022-09-01 Impact factor: 4.964
Authors: Kuan Ken Lee; Dominik Stelzle; Rong Bing; Mohamed Anwar; Fiona Strachan; Sophia Bashir; David E Newby; Jasmit S Shah; Michael H Chung; Gerald S Bloomfield; Chris T Longenecker; Shashwatee Bagchi; Shyamasundaran Kottilil; Sarah Blach; Homie Razavi; Peter R Mills; Nicholas L Mills; David A McAllister; Anoop S V Shah Journal: Lancet Gastroenterol Hepatol Date: 2019-07-31