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High lipid levels in HCV patients increase risk for acute MI
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Patients with hepatitis C virus infection with high lipid levels may be at increased risk for acute myocardial infarction, according to 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, told Infectious Disease News.
Butt and colleagues evaluated 55,814 HCV–positive and 84,772 HCV–negative patients without major cardiovascular risk factors (eg, diabetes, hypertension, smoking, COPD, chronic kidney disease and HIV) to determine if HCV–positive patients are at increased risk for acute myocardial infarction (MI) due to lower total cholesterol and LDL levels. There were 4,924 acute MI events in the HCV–positive patients and 8,888 events in the HCV–negative patients. 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 suggest guidelines should 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 26-30, 2016; New Orleans.
Disclosure: The researchers report no relevant financial disclosures.