Association of hepatitis C infection and acute coronary syndrome: A case-control study.
Association of hepatitis C infection and acute coronary syndrome: A case-control study.
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DOI：
10.1097/md.0000000000026033
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发表时间：
2021-05-28
期刊：
影响因子：
1.6
通讯作者：
Bagchi S
中科院分区：
文献类型：
--
作者：
Wu A;Burrowes S;Zisman E;Brown TT;Bagchi S
丙型肝炎病毒（HCV）感染是一个巨大的国家和国际公共卫生负担。HCV与许多肝外疾病相关，并可导致与动脉粥样硬化和心血管疾病相关的代谢紊乱。我们调查了在市中心一家三级医院住院患者中，HCV感染是否与急性冠脉综合征（ACS）事件数量增加相关。我们对2015年至2018年在马里兰州医学中心住院医疗和心脏服务的至少18岁患者进行了一项匹配（年龄、性别和种族/民族）病例对照研究。 主要结局为ACS，主要暴露为HCV感染。关注的协变量包括：酒精使用、烟草使用、非法药物使用、高血压、糖尿病、人类免疫缺陷病毒感染、体重指数、血脂异常和冠心病家族史。在最终校正模型的多变量分析中纳入了双变量分析中与暴露和结局均具有显著相关性的协变量。最终样本包括1555例病例和3110例对照。近2%的病例和2.4%的对照组为HCV感染。在调整后的模型中，与无HCV感染者相比，HCV感染者发生ACS事件之间无显著相关性（比值比0.71，95%置信区间0.45-1.11）。在我们的研究人群中，我们没有发现HCV感染与ACS之间存在显著相关性。然而，考虑到现有的混合文献，HCV和ACS之间的关联需要在未来的前瞻性队列和/或干预性研究中进一步研究。
Infections with hepatitis C virus (HCV) represent a substantial national and international public health burden. HCV has been associated with numerous extrahepatic conditions and can lead to metabolic derangements that are associated with atherosclerosis and cardiovascular disease. We investigated whether HCV infection is associated with an increased number of acute coronary syndrome (ACS) events among hospitalized patients in an inner-city tertiary hospital. We performed a matched (age, sex, and race/ethnicity) case-control study on patients at least 18 years old admitted to inpatient medical and cardiac services at the University of Maryland Medical Center from 2015 through 2018. The primary outcome was ACS and the primary exposure was HCV infection. Covariates of interest included: alcohol use, tobacco use, illicit drug use, hypertension, diabetes mellitus, human immunodeficiency virus infection, body mass index, dyslipidemia, and family history of coronary heart disease. Covariates with significant associations with both exposure and outcome in bivariate analyses were included in the multivariable analyses of the final adjusted model. There were 1555 cases and 3110 controls included in the final sample. Almost 2% of cases and 2.4% of controls were HCV infected. In adjusted models, there was no significant association found between experiencing an ACS event in those with HCV infection compared to those without HCV infection (odds ratio 0.71, 95% confidence interval 0.45–1.11). We found no significant association between HCV infection and ACS in our study population. However, given the mixed existing literature, the association between HCV and ACS warrants further investigation in future prospective cohort and/or interventional studies.