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联合疗法治疗慢性丙型肝炎病毒对心血管系统的影响。

Effect of Chronic Hepatitis C Virus Treatment by Combination Therapy on Cardiovascular System.

作者信息

Biomy Reda, Abdelshafy Mohamed, Abdelmonem Ahmed, Abu-Elenin Hesham, Ghaly George

机构信息

Faculty of Medicine, Kafrelsheikh University, Kafr El-Sheikh, Egypt.

Faculty of Medicine, Benha University, Benha, Egypt.

出版信息

Clin Med Insights Cardiol. 2017 Jun 22;11:1179546817713204. doi: 10.1177/1179546817713204. eCollection 2017.

Abstract

BACKGROUND

The prevalence of hepatitis C virus (HCV) in Egypt is quite high, and the combined oral direct-acting antiviral agents (DAAs) may have impressive results.

OBJECTIVE

To assess the cardiovascular effects of DAAs in patients with HCV.

METHODS

A total of 170 patients with HCV were divided into 2 groups: first group (100 patients) received triple combination therapy (pegylated interferon alfa, sofosbuvir, and ribavirin, whereas the second group (70 patients) received dual combination therapy (sofosbuvir and simeprevir). Group 1 patients were followed up for 1 year more than 3 visits, whereas group 2 patients were followed up for 6 months more than 2 visits; and the end point of the study was the development of a major cardiovascular event (eg, congestive heart failure, echocardiographic evidence of left ventricular dysfunction, occurrence of significant arrhythmias, or acute coronary syndrome). The following parameters were accomplished: medical history and clinical examination, electrocardiogram, echo-Doppler study, and laboratory investigations.

RESULTS

No significant differences were found between the 2 study groups regarding demographic criteria. None of the both group patients had developed any major cardiac event. No significant changes were observed regarding ST-T wave abnormalities, arrhythmias, or QT interval. None of the both group patients developed echocardiographic regional wall motion abnormalities at baseline or at study end. Systolic function parameters showed minute nonsignificant changes over study visits. Diastolic function parameters showed nonsignificant changes between baseline and 6-month and 12-month visits.

CONCLUSIONS

The DAAs used in combination regimen with interferon or used orally in combination do not significantly affect the cardio-vascular system.

摘要

背景

埃及丙型肝炎病毒(HCV)的流行率相当高,联合口服直接抗病毒药物(DAAs)可能会产生显著效果。

目的

评估DAAs对HCV患者心血管系统的影响。

方法

总共170例HCV患者被分为2组:第一组(100例患者)接受三联联合疗法(聚乙二醇化干扰素α、索磷布韦和利巴韦林),而第二组(70例患者)接受双联联合疗法(索磷布韦和simeprevir)。第一组患者随访1年以上,进行3次以上访视,而第二组患者随访6个月以上,进行2次以上访视;研究的终点是发生重大心血管事件(如充血性心力衰竭、左心室功能障碍的超声心动图证据、显著心律失常的发生或急性冠状动脉综合征)。完成了以下参数的测定:病史和临床检查、心电图、超声多普勒研究和实验室检查。

结果

在人口统计学标准方面,两个研究组之间未发现显著差异。两组患者均未发生任何重大心脏事件。在ST-T波异常、心律失常或QT间期方面未观察到显著变化。两组患者在基线或研究结束时均未出现超声心动图区域壁运动异常。收缩功能参数在研究访视期间显示出微小的非显著变化。舒张功能参数在基线与6个月和12个月访视之间无显著变化。

结论

与干扰素联合使用或口服联合使用的DAAs对心血管系统无显著影响。

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