4 years ago

Prognostic value of viral eradication for major adverse cardiovascular events in hepatitis C cirrhotic patients

The objective was to examine the role of a sustained virological response (SVR) on major adverse cardiovascular events (MACE) in patients with compensated hepatitis C virus (HCV) cirrhosis. Methods Patients with the following criteria were enrolled in 35 French centers a) biopsy-proven HCV cirrhosis; b) Child-Pugh A; c) positive viremia; and d) no prior liver complication, and then prospectively followed. All patients received HCV treatment after inclusion. MACE included stroke, myocardial infarction, ischemic heart disease, heart failure, peripheral arterial disease, cardiac arrest and cardiovascular death. SVR, defined as negative viremia twelve weeks post-treatment, was considered as a time-dependent covariate, and its effect on MACE occurrence was assessed. The median follow up was 57.5months, ending in December 2015. Results 62/878 (7.1%) patients presented a total of 79 MACE. The main predictive baseline factors of MACE were Asian ethnic origin, past history of MACE, arterial hypertension, diabetes mellitus, current smoking, low serum albumin level, high total bilirubin level, and low platelet count. In multivariate analysis, SVR was associated with a decreased risk of MACE (HR=0.35, 95% CI: 0.09; 0.97, P =.044), while Asian ethnic origin, arterial hypertension, smoking and low serum albumin level remained predictive of MACE occurrence. The 5-year survival rate was 60.1% versus 87.5% in patients who did versus those who did not present a MACE (P <.001). Conclusion In patients with compensated HCV-related cirrhosis, Asian ethnic origin, arterial hypertension, smoking and low serum albumin are independent predictive factors of cardiovascular events, while a sustained virological response is associated with a decreased rate of cardiovascular events.

Publisher URL: www.sciencedirect.com/science

DOI: S000287031730354X

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