Risk of Acute Myocardial Infarction Among Hepatitis C Virus (HCV)-Positive and HCV-Negative Men at Various Lipid Levels: Results From ERCHIVES

Background. Risk of acute myocardial infarction (AMI) among hepatitis C virus (HCV)-positive versus HCV-negative persons with similar lipid levels is unknown. We determined incident AMI rates among HCV-positive and HCV-negative men among various lipid strata. Methods. We created a propensity score m...

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Published in:Clinical infectious diseases 2017-08, Vol.65 (4), p.557-565
Main Authors: Butt, Adeel A., Yan, Peng, Chew, Kara W., Currier, Judith, Corey, Kathleen, Chung, Raymond T., Shuaib, Ashfaq, Abou-Samra, Abdul-Badi, Butler, Javed, Freiberg, Matthew S.
Format: Article
Language:English
Subjects:
Age
and Commentaries
ARTICLES AND COMMENTARIES
Cardiovascular diseases
Cholesterol
Cohort Studies
Confidence intervals
Editor's Choice
Health risks
Heart attacks
Hepatitis
Hepatitis C
Hepatitis C - complications
Hepatitis C - epidemiology
Humans
Incidence
Lipids
Lipids - blood
Low density lipoprotein
Male
Men
Middle Aged
Myocardial infarction
Myocardial Infarction - complications
Myocardial Infarction - epidemiology
Propensity Score
Risk assessment
Risk Factors
Strata
Therapy
Viruses
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container_issue 4
container_start_page 557
container_title Clinical infectious diseases
container_volume 65
creator Butt, Adeel A.
Yan, Peng
Chew, Kara W.
Currier, Judith
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Shuaib, Ashfaq
Abou-Samra, Abdul-Badi
Butler, Javed
Freiberg, Matthew S.
description Background. Risk of acute myocardial infarction (AMI) among hepatitis C virus (HCV)-positive versus HCV-negative persons with similar lipid levels is unknown. We determined incident AMI rates among HCV-positive and HCV-negative men among various lipid strata. Methods. We created a propensity score matched (PSM) cohort and a low cardiovascular disease (CVD) risk cohort. Primary outcome was incident AMI rates by HCV status in each lipid strata using National Cholesterol Program guidelines for lipid strata. Results. We identified 85 863 HCV-positive and HCV-negative men in the PSM population. The incidence rates/1000 patient-years (95% confidence interval [CI]) for AMI among total cholesterol (TC) 200−239 stratum were 5.3 (4.89, 5.71) for HCV-positive versus 4.71 (4.42, 5) for HCV-negative men (P = .02) and for TC >240 mg/dL were 7.38 (6.49, 8.26) versus 6.17 (5.64, 6.71) (P = .02). For low-density lipoprotein cholesterol (LDL) of 130−159 mg/dL, AMI rates were 5.44 (4.97, 5.91) for HCV-positive and 4.81 (4.48, 5.14) for HCV-negative men (P = .03). The rise in risk with increasing lipid levels was greater in younger HCV-positive than in HCV-negative men (e.g., TC > 240 mg/dL: age >50 HR 1.38 [HCV-positive] and 1.12 [HCV-negative]; age ≤50 HR 1.6 [HCV-positive] and 1.29 [HCV-negative]), and more profoundly altered in HCV-positive men by lipid lowering therapy (change in HR with lipid-lowering therapy for TC >240 mg/dL from 1.82 to 1.19 [HCV-positive] from 1.48 to 1.03 [HCV-negative]). Conclusions. HCV-positive men have a higher risk of AMI than HCV-negative men at higher TC/LDL levels; this risk is more pronounced at a younger age. Lipid lowering therapy significantly reduces this risk, with more profound reduction among HCV-positive versus HCV-negative men at similar lipid levels.
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Risk of acute myocardial infarction (AMI) among hepatitis C virus (HCV)-positive versus HCV-negative persons with similar lipid levels is unknown. We determined incident AMI rates among HCV-positive and HCV-negative men among various lipid strata. Methods. We created a propensity score matched (PSM) cohort and a low cardiovascular disease (CVD) risk cohort. Primary outcome was incident AMI rates by HCV status in each lipid strata using National Cholesterol Program guidelines for lipid strata. Results. We identified 85 863 HCV-positive and HCV-negative men in the PSM population. The incidence rates/1000 patient-years (95% confidence interval [CI]) for AMI among total cholesterol (TC) 200−239 stratum were 5.3 (4.89, 5.71) for HCV-positive versus 4.71 (4.42, 5) for HCV-negative men (P = .02) and for TC &gt;240 mg/dL were 7.38 (6.49, 8.26) versus 6.17 (5.64, 6.71) (P = .02). For low-density lipoprotein cholesterol (LDL) of 130−159 mg/dL, AMI rates were 5.44 (4.97, 5.91) for HCV-positive and 4.81 (4.48, 5.14) for HCV-negative men (P = .03). The rise in risk with increasing lipid levels was greater in younger HCV-positive than in HCV-negative men (e.g., TC &gt; 240 mg/dL: age &gt;50 HR 1.38 [HCV-positive] and 1.12 [HCV-negative]; age ≤50 HR 1.6 [HCV-positive] and 1.29 [HCV-negative]), and more profoundly altered in HCV-positive men by lipid lowering therapy (change in HR with lipid-lowering therapy for TC &gt;240 mg/dL from 1.82 to 1.19 [HCV-positive] from 1.48 to 1.03 [HCV-negative]). Conclusions. HCV-positive men have a higher risk of AMI than HCV-negative men at higher TC/LDL levels; this risk is more pronounced at a younger age. Lipid lowering therapy significantly reduces this risk, with more profound reduction among HCV-positive versus HCV-negative men at similar lipid levels.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1093/cid/cix359</identifier><identifier>PMID: 28444148</identifier><language>eng</language><publisher>United States: Oxford University Press</publisher><subject>Age ; and Commentaries ; ARTICLES AND COMMENTARIES ; Cardiovascular diseases ; Cholesterol ; Cohort Studies ; Confidence intervals ; Editor's Choice ; Health risks ; Heart attacks ; Hepatitis ; Hepatitis C ; Hepatitis C - complications ; Hepatitis C - epidemiology ; Humans ; Incidence ; Lipids ; Lipids - blood ; Low density lipoprotein ; Male ; Men ; Middle Aged ; Myocardial infarction ; Myocardial Infarction - complications ; Myocardial Infarction - epidemiology ; Propensity Score ; Risk assessment ; Risk Factors ; Strata ; Therapy ; Viruses</subject><ispartof>Clinical infectious diseases, 2017-08, Vol.65 (4), p.557-565</ispartof><rights>Copyright © 2017 Oxford University Press on behalf of the Infectious Diseases Society of America</rights><rights>The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com</rights><rights>Copyright Oxford University Press, UK Aug 15, 2017</rights><rights>The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com. 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c494t-185a9201fa5714fa085046f6ca0e3757495f7e8feffe8dd0aab842749831875e3</citedby><cites>FETCH-LOGICAL-c494t-185a9201fa5714fa085046f6ca0e3757495f7e8feffe8dd0aab842749831875e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/26375337$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/26375337$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>230,315,786,790,891,27957,27958,58593,58826</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28444148$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Butt, Adeel A.</creatorcontrib><creatorcontrib>Yan, Peng</creatorcontrib><creatorcontrib>Chew, Kara W.</creatorcontrib><creatorcontrib>Currier, Judith</creatorcontrib><creatorcontrib>Corey, Kathleen</creatorcontrib><creatorcontrib>Chung, Raymond T.</creatorcontrib><creatorcontrib>Shuaib, Ashfaq</creatorcontrib><creatorcontrib>Abou-Samra, Abdul-Badi</creatorcontrib><creatorcontrib>Butler, Javed</creatorcontrib><creatorcontrib>Freiberg, Matthew S.</creatorcontrib><title>Risk of Acute Myocardial Infarction Among Hepatitis C Virus (HCV)-Positive and HCV-Negative Men at Various Lipid Levels: Results From ERCHIVES</title><title>Clinical infectious diseases</title><addtitle>Clin Infect Dis</addtitle><description>Background. Risk of acute myocardial infarction (AMI) among hepatitis C virus (HCV)-positive versus HCV-negative persons with similar lipid levels is unknown. We determined incident AMI rates among HCV-positive and HCV-negative men among various lipid strata. Methods. We created a propensity score matched (PSM) cohort and a low cardiovascular disease (CVD) risk cohort. Primary outcome was incident AMI rates by HCV status in each lipid strata using National Cholesterol Program guidelines for lipid strata. Results. We identified 85 863 HCV-positive and HCV-negative men in the PSM population. The incidence rates/1000 patient-years (95% confidence interval [CI]) for AMI among total cholesterol (TC) 200−239 stratum were 5.3 (4.89, 5.71) for HCV-positive versus 4.71 (4.42, 5) for HCV-negative men (P = .02) and for TC &gt;240 mg/dL were 7.38 (6.49, 8.26) versus 6.17 (5.64, 6.71) (P = .02). For low-density lipoprotein cholesterol (LDL) of 130−159 mg/dL, AMI rates were 5.44 (4.97, 5.91) for HCV-positive and 4.81 (4.48, 5.14) for HCV-negative men (P = .03). The rise in risk with increasing lipid levels was greater in younger HCV-positive than in HCV-negative men (e.g., TC &gt; 240 mg/dL: age &gt;50 HR 1.38 [HCV-positive] and 1.12 [HCV-negative]; age ≤50 HR 1.6 [HCV-positive] and 1.29 [HCV-negative]), and more profoundly altered in HCV-positive men by lipid lowering therapy (change in HR with lipid-lowering therapy for TC &gt;240 mg/dL from 1.82 to 1.19 [HCV-positive] from 1.48 to 1.03 [HCV-negative]). Conclusions. HCV-positive men have a higher risk of AMI than HCV-negative men at higher TC/LDL levels; this risk is more pronounced at a younger age. 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A. Butt, University Drive C, Building 30, Mailstop 151, Pittsburgh, PA 15240 (aab2005@qatar-med.cornell.edu).</notes><abstract>Background. Risk of acute myocardial infarction (AMI) among hepatitis C virus (HCV)-positive versus HCV-negative persons with similar lipid levels is unknown. We determined incident AMI rates among HCV-positive and HCV-negative men among various lipid strata. Methods. We created a propensity score matched (PSM) cohort and a low cardiovascular disease (CVD) risk cohort. Primary outcome was incident AMI rates by HCV status in each lipid strata using National Cholesterol Program guidelines for lipid strata. Results. We identified 85 863 HCV-positive and HCV-negative men in the PSM population. The incidence rates/1000 patient-years (95% confidence interval [CI]) for AMI among total cholesterol (TC) 200−239 stratum were 5.3 (4.89, 5.71) for HCV-positive versus 4.71 (4.42, 5) for HCV-negative men (P = .02) and for TC &gt;240 mg/dL were 7.38 (6.49, 8.26) versus 6.17 (5.64, 6.71) (P = .02). For low-density lipoprotein cholesterol (LDL) of 130−159 mg/dL, AMI rates were 5.44 (4.97, 5.91) for HCV-positive and 4.81 (4.48, 5.14) for HCV-negative men (P = .03). The rise in risk with increasing lipid levels was greater in younger HCV-positive than in HCV-negative men (e.g., TC &gt; 240 mg/dL: age &gt;50 HR 1.38 [HCV-positive] and 1.12 [HCV-negative]; age ≤50 HR 1.6 [HCV-positive] and 1.29 [HCV-negative]), and more profoundly altered in HCV-positive men by lipid lowering therapy (change in HR with lipid-lowering therapy for TC &gt;240 mg/dL from 1.82 to 1.19 [HCV-positive] from 1.48 to 1.03 [HCV-negative]). Conclusions. HCV-positive men have a higher risk of AMI than HCV-negative men at higher TC/LDL levels; this risk is more pronounced at a younger age. Lipid lowering therapy significantly reduces this risk, with more profound reduction among HCV-positive versus HCV-negative men at similar lipid levels.</abstract><cop>United States</cop><pub>Oxford University Press</pub><pmid>28444148</pmid><doi>10.1093/cid/cix359</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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source JSTOR Archival Journals and Primary Sources Collection; Oxford University Press
subjects Age
and Commentaries
ARTICLES AND COMMENTARIES
Cardiovascular diseases
Cholesterol
Cohort Studies
Confidence intervals
Editor's Choice
Health risks
Heart attacks
Hepatitis
Hepatitis C
Hepatitis C - complications
Hepatitis C - epidemiology
Humans
Incidence
Lipids
Lipids - blood
Low density lipoprotein
Male
Men
Middle Aged
Myocardial infarction
Myocardial Infarction - complications
Myocardial Infarction - epidemiology
Propensity Score
Risk assessment
Risk Factors
Strata
Therapy
Viruses
title Risk of Acute Myocardial Infarction Among Hepatitis C Virus (HCV)-Positive and HCV-Negative Men at Various Lipid Levels: Results From ERCHIVES
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