July 4, 2013

Higher Prevalence and More Severe Coronary Artery Disease in Hepatitis C Virus-infected Patients: A Case Control Study

Journal of Clinical & Experimental Hepatology

Article in Press

Presented in the plenary session of the annual scientific meeting of the American College of Gastroenterology, October 27–November 2, 2011, Washington, D.C, and was awarded the 2011 Astra-Zenica/Senior Fellow Award.

Sanjaya K. Satapathy, Yun Ju Kim, Ashish Kataria, Arash Shifteh, Rohan Bhansali, Maurice A. Cerulli, David Bernstein

Received 21 March 2013; accepted 9 May 2013. published online 24 May 2013.
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An association of Coronary artery disease (CAD) with hepatitis C (HCV) has been suggested, but definitive data are still lacking.


Our study sought to estimate the prevalence and severity of CAD in HCV patients compared to with age-, sex-, and race-matched controls without HCV infection.

Subjects and methods

63 HCV-infected patients were compared with 63 age, race, and sex-matched controls without HCV infection undergoing coronary angiography for evaluation of CAD. CAD was defined as more than a 50% blockage in any of the proximal coronary arteries on angiogram. The severity of the stenosis was defined by the modified Reardon severity scoring system: <50% stenosis of the luminal diameter, 1 point; 50–74%, 2 points; 75–99%, 3 points; 100% or total obstruction, 4 points. The points for each lesion in the proximal coronary circulation were summed to give the score for severity.


A significantly higher prevalence of CAD was noted in the HCV population (69.8% vs. 47.6%, = 0.01). The combined Reardon's severity score in the HCV group was significantly higher compared to the controls (6.26 ± 5.39 vs. 2.6 ± 3.03, P < 0.0005). Additionally, significant multivessel CAD (>50% stenosis and ≥2 vessels involved) was also noted significantly more commonly in the HCV group compared to controls (57.1% vs. 15.9%, P < 0.0005).


In this retrospective study the prevalence and severity of CAD was higher in HCV patients who were evaluated for CAD by angiogram compared with matched non-HCV patients. HCV-positive status is potentially a risk factor for CAD.

Keywords: hepatitis C, coronary artery disease, prevalence

Abbreviations: CAD, coronary artery disease, HCV, hepatitis C virus, DM, diabetes mellitus, HDL, high density lipoprotein, LDL, low density lipoprotein, IVDU, intravenous drug use, ACE, angiotensin converting enzyme, IR, insulin resistance


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