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Hepatitis C Virus Infection and Coronary Artery Disease Risk: A Systematic Review of the Literature

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Abstract

Background and Aims

While hepatitis C virus (HCV) infection has been implicated in increasing the risk of coronary artery disease (CAD), conflicting reports exist regarding this association. We performed a systematic review to further investigate this association.

Methods

We conducted a PubMed search of original research articles from January 1, 1995 to June 30, 2013 to identify case–control and cohort studies evaluating the association between HCV and CAD using keyword terms [“hepatitis c” or “HCV”] and [“coronary artery disease” or “heart disease” or “atherosclerosis.”] The primary CAD-related endpoints included myocardial infarction, congestive heart failure, need for coronary artery bypass grafting, or transluminal percutaneous coronary angioplasty. Binary outcomes are reported as odds ratios (OR) with 95 % confidence interval (CI).

Results

We identified five studies (four cohort studies and one case–control study) that met our inclusion criteria. A significant association between HCV and CAD was demonstrated in one cohort study (adjusted HR 1.27; 95 % CI 1.22–1.31). One cohort study demonstrated a decreased risk of CAD associated with HCV (adjusted OR 0.74; 95 % CI 0.71–0.76). The remaining studies did not find a significant association between HCV and risk of CAD.

Conclusions

The current systematic review demonstrates that the association between HCV and CAD remains unclear. We need more large, long-term cohort studies with clear definitions of patient population and endpoints to better ascertain the association between HCV and CAD.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA

    Robert J. Wong & Aijaz Ahmed

  2. Clinical Epidemiology and Outcomes Program, Houston Veteran Affairs Health Services Research, Development Center of Excellence, Section of Gastroenterology and Hepatology, Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Michael E. DeBakey Veteran Affairs Medical Center, 2002 Holcombe Blvd. (152), Houston, TX, USA

    Fasiha Kanwal

  3. Center of Liver Diseases, Department of Medicine, Betty and Guy Beatty Center for Integrated Research, Inova Fairfax Hospital, VCU-Inova Campus, 3300 Gallows Road, Falls Church, VA, USA

    Zobair M. Younossi

  4. Division of Gastroenterology and Hepatology, Stanford University School of Medicine, 750 Welch Road, Suite 210, Palo Alto, CA, 94304, USA

    Robert J. Wong

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  1. Robert J. Wong
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  2. Fasiha Kanwal
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  4. Aijaz Ahmed
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Correspondence to Robert J. Wong.

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Wong, R.J., Kanwal, F., Younossi, Z.M. et al. Hepatitis C Virus Infection and Coronary Artery Disease Risk: A Systematic Review of the Literature. Dig Dis Sci 59, 1586–1593 (2014). https://doi.org/10.1007/s10620-014-3222-3

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  • DOI: https://doi.org/10.1007/s10620-014-3222-3

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