Ming-Shyan Lin1,2, Chang-Min Chung2, Ming-Ling Chang3, Mei-Yen Chen4,5, Shih-Tai Chang2, Pao-Hsien Chu6, Tien-Hsing Chen1, Wey-Yil Lin7, Tung-Jung Huang8, Yu-Sheng Lin2. 1. Department of Cardiology, Chang Gung Memorial Hospital. 2. Department of Cardiology, Heart Failure Center, Chang Gung Memorial Hospital. 3. Liver Research Center and Division of Hepatology, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital. 4. College of Nursing & Graduate Institute of Nursing, Chang Gung University of Science and Technology. 5. Department of Nursing, Chang Gung University. 6. Department of Cardiology, Heart Failure Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University. 7. Department of Neurology, Landseed Hospital. 8. Department of Pulmonary Disease and Critical Care, Chang Gung Memorial Hospital.
Abstract
BACKGROUND: Although hepatitis C virus (HCV) is a known risk factor for cardiovascular disease, whether antiviral therapy (AVT) can reduce heart failure (HF) hospitalizations is unknown.Methods and Results: In this population-based cohort study, we used data from the Taiwan National Health Insurance Research Database to evaluate the effect of interferon-based therapy (IBT) on cardiovascular events in patients with chronic HCV infection. Clinical outcomes evaluated included HF hospitalizations; a composite of acute myocardial infarction, ischemic stroke, and peripheral artery disease; all-cause death; and cardiovascular death. Of 83,229 eligible patients with chronic HCV infection, we compared 16,284 patients who received IBT with untreated subjects after propensity score matching. Patients who received IBT were less likely to be hospitalized for HF compared with untreated subjects (incidence density.ID, 0.9 vs. 1.5 events per 103person-years; hazard ratio.HR, 0.58; 95% confidence interval.CI, 0.42-0.79; P=0.001). Compared with untreated subjects, the treated group had significantly lower risk of composite vascular events (ID, 3.7 vs. 5.0 events per 103person-years; P<0.001), all-cause death (ID, 5.6 vs. 17.2 events per 103person-years; P<0.001), and cardiovascular death (ID, 0.2 vs. 0.6 events per 103person-years; P=0.001). CONCLUSIONS: AVT for chronic HCV infection might offer protection against HF hospitalizations, critical vascular events, and cardiovascular death beyond known beneficial effects.
BACKGROUND: Although hepatitis C virus (HCV) is a known risk factor for cardiovascular disease, whether antiviral therapy (AVT) can reduce heart failure (HF) hospitalizations is unknown.Methods and Results: In this population-based cohort study, we used data from the Taiwan National Health Insurance Research Database to evaluate the effect of interferon-based therapy (IBT) on cardiovascular events in patients with chronic HCV infection. Clinical outcomes evaluated included HF hospitalizations; a composite of acute myocardial infarction, ischemic stroke, and peripheral artery disease; all-cause death; and cardiovascular death. Of 83,229 eligible patients with chronic HCV infection, we compared 16,284 patients who received IBT with untreated subjects after propensity score matching. Patients who received IBT were less likely to be hospitalized for HF compared with untreated subjects (incidence density.ID, 0.9 vs. 1.5 events per 103person-years; hazard ratio.HR, 0.58; 95% confidence interval.CI, 0.42-0.79; P=0.001). Compared with untreated subjects, the treated group had significantly lower risk of composite vascular events (ID, 3.7 vs. 5.0 events per 103person-years; P<0.001), all-cause death (ID, 5.6 vs. 17.2 events per 103person-years; P<0.001), and cardiovascular death (ID, 0.2 vs. 0.6 events per 103person-years; P=0.001). CONCLUSIONS: AVT for chronic HCV infection might offer protection against HF hospitalizations, critical vascular events, and cardiovascular death beyond known beneficial effects.
Entities:
Keywords:
Antiviral therapy; Heart failure; Hepatitis C virus; National Health Insurance Research Database; Pegylated interferon
Authors: Mohammad Said Ramadan; Filomena Boccia; Simona Maria Moretto; Fabrizio De Gregorio; Massimo Gagliardi; Domenico Iossa; Emanuele Durante-Mangoni; Rosa Zampino Journal: J Clin Med Date: 2022-09-29 Impact factor: 4.964