Advertisement

Hepatitis C virus infection and risk of coronary artery disease: A meta-analysis

Published:April 18, 2019DOI:https://doi.org/10.1016/j.ejim.2019.03.004

      Abstract

      Background

      A few recent studies have demonstrated that hepatitis C virus (HCV) infection was associated with coronary artery diseases (CAD). However, there still existed studies did not confirm this correlation.

      Objective

      The objective of this study was to evaluate the association between HCV infection and CAD using a meta-analysis.

      Methods

      Pubmed, Embase, and Cochrane library databases were systemically searched. Data were extracted by two independent reviewers and pooled odds ratio (OR) and relative risk (RR) with 95% confidence interval (CI) were calculated using the fixed and random effects models.

      Results

      Eight cohort studies and six case-control and cross-sectional studies were enrolled in this meta-analysis. In the cohort studies, the overall RR and 95% CIs of HCV infection for CAD was 1.25, 1.12–1.40 in random effects model. For the case-control and cross-sectional studies, the overall OR and 95% CIs of HCV infection for CAD were 1.94, 1.58–2.38 in fixed effects model. No publication bias was found in this meta-analysis.

      Conclusions

      This meta-analysis showed that HCV infection was a risk factor for CAD.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to European Journal of Internal Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Poynard T.
        • Yuen M.F.
        • Ratziu V.
        • Lai C.L.
        Viral hepatitis C.
        Lancet. 2003; 362: 2095-2100
        • Matsumori A.
        • Shimada T.
        • Chapman N.M.
        • Tracy S.M.
        • Mason J.W.
        Myocarditis and heart failure associated with hepatitis C virus infection.
        J Card Fail. 2006; 12: 293-298
        • Sanchez M.J.
        • Bergasa N.V.
        Hepatitis C associated cardiomyopathy: potential pathogenic mechanisms and clinical implications.
        Med Sci Monit. 2008; 14: RA55-63
        • Vassalle C.
        • Masini S.
        • Bianchi F.
        • Zucchelli G.C.
        Evidence for association between hepatitis C virus seropositivity and coronary artery disease.
        Heart. 2004; 90: 565-566
        • Lee M.H.
        • Yang H.I.
        • Wang C.H.
        • Jen C.L.
        • Yeh S.H.
        • Liu C.J.
        • et al.
        Hepatitis C virus infection and increased risk of cerebrovascular disease.
        Stroke. 2010; 41: 2894-2900
        • Li H.
        • Huang M.H.
        • Jiang J.D.
        • Peng Z.G.
        Hepatitis C: from inflammatory pathogenesis to anti-inflammatory/hepatoprotective therapy.
        World J Gastroenterol. 2018; 24: 5297-5311
        • Ríos-Ocampo W.A.
        • Navas M.C.
        • Faber K.N.
        • Daemen T.
        • Moshage H.
        The cellular stress response in hepatitis C virus infection: a balancing act to promote viral persistence and host cell survival.
        Virus Res. 2019; 263: 1-8
        • Adinolfi L.E.
        • Gambardella M.
        • Andreana A.
        • Tripodi M.F.
        • Utili R.
        • Ruggiero G.
        Steatosis accelerates the progression of liver damage of chronic hepatitis C patients and correlates with specific HCV genotype and visceral obesity.
        Hepatology. 2001; 33: 1358-1364
        • Goossens N.
        • Negro F.
        Cardiovascular manifestations of hepatitis C virus.
        Clin Liver Dis. 2017; 21: 465-473
        • Fukui M.
        • Kitagawa Y.
        • Nakamura N.
        • Yoshikawa T.
        Hepatitis C virus and atherosclerosis in patients with type 2 diabetes.
        JAMA. 2003; 289: 1245-1246
        • DerSimonian R.
        • Laird N.
        Meta-analysis in clinical trials.
        Control Clin Trials. 1986; 7: 177-188
        • Mantel N.
        • Haenszel W.
        Statistical aspects of the analysis of data from retrospective studies of disease.
        J Natl Cancer Inst. 1959; 22: 719-748
        • Higgins J.P.
        • Thompson S.G.
        • Deeks J.J.
        • Altman D.G.
        Measuring inconsistency in meta-analyses.
        BMJ. 2003; 327: 557-560
        • Egger M.
        • Davey Smith G.
        • Schneider M.
        • Minder C.
        Bias in meta-analysis detected by a simple, graphical test.
        BMJ. 1997; 315: 629-634
        • Pothineni N.V.
        • Rochlani Y.
        • Vallurupalli S.
        • Kovelamudi S.
        • Ahmed Z.
        • Hakeem A.
        • et al.
        Comparison of angiographic burden of coronary artery disease in patients with versus without hepatitis C infection.
        Am J Cardiol. 2015; 116: 1041-1044
        • Butt A.A.
        • Khan U.A.
        • McGinnis K.A.
        • Skanderson M.
        • Kent Kwoh C.
        Co-morbid medical and psychiatric illness and substance abuse in HCV-infected and uninfected veterans.
        J Viral Hepat. 2007; 14: 890-896
        • Butt A.A.
        • Xiaoqiang W.
        • Budoff M.
        • Leaf D.
        • Kuller L.H.
        • Justice A.C.
        Hepatitis C virus infection and the risk of coronary disease.
        Clin Infect Dis. 2009; 49: 225-232
        • Pothineni N.V.
        • Delongchamp R.
        • Vallurupalli S.
        • Ding Z.
        • Dai Y.
        • Hagedorn C.H.
        • et al.
        Impact of hepatitis C seropositivity on the risk of coronary heart disease events.
        Am J Cardiol. 2014; 114: 1841-1845
        • Satapathy S.K.
        • Kim Y.J.
        • Kataria A.
        • Shifteh A.
        • Bhansali R.
        • Cerulli M.A.
        • et al.
        Higher prevalence and more severe coronary artery disease in hepatitis C virus-infected patients: a case control Study.
        J Clin Exp Hepatol. 2013; 3: 186-191
        • Ramdeen N.
        • Aronow W.S.
        • Chugh S.
        • Asija A.
        Patients undergoing coronary angiography because of chest pain with hepatitis C virus seropositivity have a higher prevalence of obstructive coronary artery disease.
        Arch Med Sci. 2008; 4: 452-454
        • Roed T.
        • Kristoffersen U.S.
        • Knudsen A.
        • Wiinberg N.
        • Lebech A.M.
        • Almdal T.
        • et al.
        Increased prevalence of coronary artery disease risk markers in patients with chronic hepatitis C--a cross-sectional study.
        Vasc Health Risk Manag. 2014; 10: 55-62
        • Freiberg M.S.
        • Chang C.C.
        • Skanderson M.
        • McGinnis K.
        • Kuller L.H.
        • Kraemer K.L.
        • et al.
        The risk of incident coronary heart disease among veterans with and without HIV and hepatitis C.
        Circ Cardiovasc Qual Outcomes. 2011; 4: 425-432
        • Younossi Z.M.
        • Stepanova M.
        • Nader F.
        • Younossi Z.
        • Elsheikh E.
        Associations of chronic hepatitis C with metabolic and cardiac outcomes.
        Aliment Pharmacol Ther. 2013; 37: 647-652
        • Tsui J.I.
        • Whooley M.A.
        • Monto A.
        • Seal K.
        • Tien P.C.
        • Shlipak M.
        Association of hepatitis C virus seropositivity with inflammatory markers and heart failure in persons with coronary heart disease: data from the Heart and Soul study.
        J Card Fail. 2009; 15: 451-456
        • Alyan O.
        • Kacmaz F.
        • Ozdemir O.
        • Deveci B.
        • Astan R.
        • Celebi A.S.
        • et al.
        Hepatitis C infection is associated with increased coronary artery atherosclerosis defined by modified Reardonseverity score system.
        Circ J. 2008; 72: 1960-1965
        • Forde K.A.
        • Haynes K.
        • Troxel A.B.
        • Trooskin S.
        • Osterman M.T.
        • Kimmel S.E.
        • et al.
        Risk of myocardial infarction associated with chronic hepatitis C virus infection: a population-based cohort study.
        J Viral Hepat. 2012; 19: 271-277
        • Arcari C.M.
        • Nelson K.E.
        • Netski D.M.
        • Nieto F.J.
        • Gaydos C.A.
        No association between hepatitis C virus seropositivity and acute myocardial infarction.
        Clin Infect Dis. 2006; 43: e53-e56
        • Enger C.
        • Forssen U.M.
        • Bennett D.
        • Theodore D.
        • Shantakumar S.
        • McAfee A.
        Thromboembolic events among patients with hepatitis C virus infection and cirrhosis: a matched-cohort study.
        Adv Ther. 2014; 31: 891-903
        • Shoeib O.
        • Ashmawy M.
        • Badr S.
        • El Amroosy M.
        Association between coronary artery disease and hepatitis C virus seropositivity.
        East Mediterr Health J. 2018; 24: 618-623
        • Bassendine M.F.
        • Nielsen S.U.
        • Bridge S.H.
        • Felmlee D.J.
        • Sheridan D.A.
        • Packard C.J.
        • et al.
        Hepatitis C virus and atherosclerosis: a legacy after virologic cure?.
        Clin Res Hepatol Gastroenterol. 2017; 41: 25-30
        • Targher G.
        • Bertolini L.
        • Padovani R.
        • Rodella S.
        • Arcaro G.
        • Day C.
        Differences and similarities in early atherosclerosis between patients with non-alcoholic steatohepatitis andchronic hepatitis B and C.
        J Hepatol. 2007; 46: 1126-1132
        • Lin M.S.
        • Guo S.E.
        • Chen M.Y.
        • Huang T.J.
        • Huang J.C.
        • Hu J.H.
        • et al.
        The impact of hepatitis C infection on ischemic heart disease via ischemic electrocardiogram.
        Am J Med Sci. 2014; 347: 478-484
        • Hung C.H.
        • Lee C.M.
        • Lu S.N.
        Hepatitis C virus-associated insulin resistance: pathogenic mechanisms and clinical implications.
        Expert Rev Anti Infect Ther. 2011; 9: 525-533
        • Ridker P.M.
        • Hennekens C.H.
        • Buring J.E.
        • Rifai N.
        C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women.
        N Engl J Med. 2000; 342: 836-843
        • Hwang S.J.
        • Ballantyne C.M.
        • Sharrett A.R.
        • Smith L.C.
        • Davis C.E.
        • Gotto Jr., A.M.
        • et al.
        Circulating adhesion molecules VCAM-1, ICAM-1, and E-selectin in carotid atherosclerosis and incident coronary heart disease cases: the Atherosclerosis Risk in Communities (ARIC) study.
        Circulation. 1997; 96: 4219-4225
        • Boddi M.
        • Abbate R.
        • Chellini B.
        • Giusti B.
        • Giannini C.
        • Pratesi G.
        • et al.
        Hepatitis C virus RNA localization in human carotid plaques.
        J Clin Virol. 2010; 47: 72-75
        • Boddi M.
        • Abbate R.
        • Chellini B.
        • Giusti B.
        • Solazzo V.
        • Soft F.
        • et al.
        HCV infection facilitates asymptomatic carotid atherosclerosis: preliminary report of HCV RNA localization inhuman carotid plaques.
        Dig Liver Dis. 2007; 39: S55-S60
        • Poller W.
        • Kaya Z.
        • Muche M.
        • Kasner M.
        • Skurk C.
        • Kappert K.
        • et al.
        High incidence of cardiac dysfunction and response to antiviral treatment in patients with chronic hepatitis C virus infection.
        Clin Res Cardiol. 2017; 106: 551-556
        • Hsu Y.C.
        • Lin J.T.
        • Ho H.J.
        • Kao Y.H.
        • Huang Y.T.
        • Hsiao N.W.
        • et al.
        Antiviral treatment for hepatitis C virus infection is associated with improved renal and cardiovascular outcomes in diabetic patients.
        Hepatology. 2014; 59: 1293-1302
        • Hsu C.S.
        • Kao J.H.
        • Chao Y.C.
        • Lin H.H.
        • Fan Y.C.
        • Huang C.J.
        • et al.
        Interferon-based therapy reduces risk of stroke in chronic hepatitis C patients: a population-based cohort study in Taiwan.
        Aliment Pharmacol Ther. 2013; 38: 415-423
        • Haji S.A.
        • Starling R.C.
        • Avery R.K.
        • Mawhorter S.
        • Tuzcu E.M.
        • Schoenhagen P.
        • et al.
        Donor hepatitis-C seropositivity is an independent risk factor for the development of accelerated coronary vasculopathy and predicts outcome after cardiac transplantation.
        J Heart Lung Transplant. 2004; 23: 277-283
        • Mostafa A.
        • Mohamed M.K.
        • Saeed M.
        • Hasan A.
        • Fontanet A.
        • Godsland I.
        • et al.
        Hepatitis C infection and clearance: impact on atherosclerosis and cardiometabolic risk factors.
        Gut. 2010; 59: 1135-1140
        • Wong R.J.
        • Kanwal F.
        • Younossi Z.M.
        • Ahmed A.
        Hepatitis C virus infection and coronary artery disease risk: a systematic review of the literature.
        Dig Dis Sci. 2014; 59: 1586-1593
        • Roed T.
        • Lebech A.M.
        • Kjaer A.
        • Weis N.
        Hepatitis C virus infection and risk of coronary artery disease: a systematic review of the literature.
        Clin Physiol Funct Imaging. 2012; 32: 421-430
        • Ambrosino P.
        • Lupoli R.
        • Di Minno A.
        • Tarantino L.
        • Spadarella G.
        • Tarantino P.
        • et al.
        The risk of coronary artery disease and cerebrovascular disease in patients with hepatitis C: a systematic review and meta-analysis.
        Int J Cardiol. 2016; 221: 746-754