This article is more than 5 years old. Information may no longer be current.
High lipid levels may increase risk for acute myocardial infarction in HCV
Click Here to Manage Email Alerts
NEW ORLEANS — Patients with hepatitis C virus infection with high lipid levels may be at increased risk for acute myocardial infarction, per data presented at IDWeek 2016.
“This is the first study to demonstrate the effect of lipid levels upon risk of acute myocardial infarction in HCV-positive and HCV-negative persons,” Adeel A. Butt, MD, MS, FACP, FIDSA, vice chair, department of medicine at Hamad Medical Corporation and professor of medicine at Weill Cornell Medical College, New York, told Healio.com/Hepatology.
Butt and colleagues evaluated 55,814 HCV-positive and 84,772 HCV-negative patients without major cardiovascular risk factors (e.g. diabetes, hypertension, smoking, COPD, chronic kidney disease and HIV) to determine if HCV-positive patients are at increased risk for acute myocardial infarction (acute MI) due to lower total cholesterol and LDL levels. There were 4,924 acute MI events in the HCV-positive and 8,888 events in the HCV-negative persons.. Acute MI rates per 1,000 patient-years of follow-up for patients with total cholesterol over 240 mg/dL were higher in HCV-positive patients (5.13, 95% CI, 4.2-6) compared with HCV-negative patients (4.35, 95% CI, 3.9-4.8). Acute MI rates per 1,000 patient-years of follow-up for patients with LDL levels over 190 mg/dL were higher in HCV-positive patients (7.02, 95% CI, 4.8-9.2) compared with HCV-negative patients (5.13, 95% CI, 4.2-6.1).
“We found an increased risk in HCV-positive patients at higher lipid strata compared to the HCV-controls,” Butt said. “We also found that the risk is seen at a younger age and at lower BMI values among HCV-positive persons at similar lipid levels,” further stating that treatment with lipid lowering agents led to a reduced risk.
There is controversy concerning whether patients with HCV have an increased risk for acute MI, according to Butt, and results of this study should prompt guidelines to be revisited.
“This study suggests that HCV-positive patients with higher lipid levels may need to be treated more aggressively at a younger age,” Butt said. “There is a need to revisit the lipid treatment guidelines for HCV-positive patients.” – by Melinda Stevens
Reference:
Butt A, et al. Abstract 1789. Presented at: IDWeek; October 25-30, 2016; New Orleans.
Disclosure: The researchers report no relevant financial disclosures.