Key result
HCV infection linked to ~12% higher 12-year mortality after acute MI.
Why the study?
The influence of hepatitis C virus infection on long-term outcomes after acute myocardial infarction was unclear.
Does hepatitis C virus (HCV) infection increase long-term mortality in patients with acute myocardial infarction?
Cohort (n=9,211)
Does hepatitis C virus (HCV) infection increase long-term mortality in patients with acute myocardial infarction?
Hazard Ratio: 1.12 (95% CI 1.06–1.18)
p-value: p=<0.0001
HCV infection, particularly when accompanied by cirrhosis, is associated with increased long-term mortality following acute myocardial infarction.
HCV may signal higher long-term mortality after AMI; hypothesis-generating and should not yet change practice.
INTRODUCTION: The influence of hepatitis C virus (HCV) infection on long-term outcomes of patients with acute myocardial infarction (AMI) is unclear. Therefore, this study aimed to analyse the impact of HCV infection on 12-year mortality rates after AMI using data from the Taiwan National Health Insurance Research Database (NHIRD). METHODS: NHIRD data for approximately 23 000 000 patients between January 2000 and December 2012 were analysed. A total of 186 112 cases of first AMI admission were identified. A total of 4659 patients with HCV infection not receiving interferon therapy were enrolled and divided into those with (n=107) or without (n=4552) cirrhosis. Using one-to-one matching, 4552 matched controls were included in the final analysis. RESULTS: The 12-year mortality rate was significantly higher in patients with AMI with HCV infection and cirrhosis than in those with HCV infection but without cirrhosis (P<0.0001) or controls (P<0.0001). Patients with HCV infection but without cirrhosis had significantly higher long-term mortality rates than the matched controls (P<0.0001). The HR for mortality was higher in patients with HCV infection (HR 1.12; 95% CI 1.06 to 1.18). HCV influenced outcomes among the subgroups of patients who were male (HR 1.15) and those who had hypertension (HR 1.14). CONCLUSIONS: HCV infection influenced the 12-year mortality rates of patients with AMI, especially those who were male and those who had hypertension. Cirrhosis further increased the long-term mortality rates of patients with AMI with HCV infection.
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Kuo et al. (2018) conducted a cohort in acute myocardial infarction (n=9,211). Hepatitis C virus (HCV) infection vs. Matched controls without HCV infection was evaluated on 12-year mortality (HR 1.12, 95% CI 1.06 to 1.18, p=<0.0001). Hepatitis C virus infection was associated with a higher 12-year mortality rate after acute myocardial infarction compared to matched controls (HR 1.12; 95% CI 1.06 to 1.18; P<0.0001).
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