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丙型肝炎病毒感染患者中冠状动脉疾病的更高患病率和更严重程度:一项病例对照研究。

Higher Prevalence and More Severe Coronary Artery Disease in Hepatitis C Virus-infected Patients: A Case Control Study.

作者信息

Satapathy Sanjaya K, Kim Yun Ju, Kataria Ashish, Shifteh Arash, Bhansali Rohan, Cerulli Maurice A, Bernstein David

机构信息

Division of Gastroenterology, NSLIJ Hofstra School of Medicine, Long Island Jewish Medical Center, 270-05 76th Avenue, New Hyde Park, NY 11040, USA ; Division of Gastroenterology, NSLIJ Hofstra School of Medicine, North Shore University Hospital, 225 Community Drive, Manhasset, NY, USA.

Department of Internal Medicine, NSLIJ Hofstra School of Medicine, Long Island Jewish Medical Center, 270-05 76th Avenue, New Hyde Park, NY 11040, USA.

出版信息

J Clin Exp Hepatol. 2013 Sep;3(3):186-91. doi: 10.1016/j.jceh.2013.05.004. Epub 2013 Jun 11.

Abstract

BACKGROUND

An association of Coronary artery disease (CAD) with hepatitis C (HCV) has been suggested, but definitive data are still lacking.

AIM

Our study sought to estimate the prevalence and severity of CAD in HCV patients compared to with age-, sex-, and race-matched controls without HCV infection.

SUBJECTS AND METHODS

63 HCV-infected patients were compared with 63 age, race, and sex-matched controls without HCV infection undergoing coronary angiography for evaluation of CAD. CAD was defined as more than a 50% blockage in any of the proximal coronary arteries on angiogram. The severity of the stenosis was defined by the modified Reardon severity scoring system: <50% stenosis of the luminal diameter, 1 point; 50-74%, 2 points; 75-99%, 3 points; 100% or total obstruction, 4 points. The points for each lesion in the proximal coronary circulation were summed to give the score for severity.

RESULTS

A significantly higher prevalence of CAD was noted in the HCV population (69.8% vs. 47.6%, = 0.01). The combined Reardon's severity score in the HCV group was significantly higher compared to the controls (6.26 ± 5.39 vs. 2.6 ± 3.03, P < 0.0005). Additionally, significant multivessel CAD (>50% stenosis and ≥2 vessels involved) was also noted significantly more commonly in the HCV group compared to controls (57.1% vs. 15.9%, P < 0.0005).

CONCLUSION

In this retrospective study the prevalence and severity of CAD was higher in HCV patients who were evaluated for CAD by angiogram compared with matched non-HCV patients. HCV-positive status is potentially a risk factor for CAD.

摘要

背景

已有研究提示冠状动脉疾病(CAD)与丙型肝炎(HCV)之间存在关联,但仍缺乏确凿数据。

目的

本研究旨在评估与年龄、性别和种族匹配的未感染HCV的对照组相比,HCV患者中CAD的患病率及严重程度。

研究对象与方法

选取63例HCV感染患者,并与63例年龄、种族和性别匹配的未感染HCV且接受冠状动脉造影以评估CAD的对照组进行比较。CAD定义为血管造影显示任何一支近端冠状动脉阻塞超过50%。狭窄严重程度采用改良的里尔登严重程度评分系统定义:管腔直径狭窄<50%,计1分;50%-74%,计2分;75%-99%,计3分;100%或完全阻塞,计4分。将近端冠状动脉循环中每个病变的分数相加得出严重程度评分。

结果

HCV感染人群中CAD的患病率显著更高(69.8%对47.6%,P = 0.01)。与对照组相比,HCV组的里尔登严重程度综合评分显著更高(6.26±5.39对2.6±3.03,P < 0.0005)。此外,与对照组相比,HCV组中显著更多见多支血管CAD(狭窄>50%且累及≥2支血管)(57.1%对15.9%,P < 0.0005)。

结论

在这项回顾性研究中,通过血管造影评估CAD的HCV患者中,CAD的患病率和严重程度高于匹配的非HCV患者。HCV阳性状态可能是CAD的一个危险因素。

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