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Article Dans Une Revue American Heart Journal Année : 2018

Prognostic value of viral eradication for major adverse cardiovascular events in hepatitis C cirrhotic patients

1 CHU Pitié-Salpêtrière [AP-HP]
2 I3 - Immunologie - Immunopathologie - Immunothérapie
3 U1162 - Génomique Fonctionnelle des Tumeurs Solides
4 Hôpital Jean Verdier [AP-HP]
5 CEpiA - Clinical Epidemiology and Ageing : Geriatrie Soins Primaires et Santé Publique
6 Pôle Recherche Clinique-Santé Publique [Mondor]
7 USPN UP13 UFR SC - Université Sorbonne Paris Nord - UFR des Sciences de la communication
8 ANRS - Agence Nationale de Recherches sur le Sida et les Hépatites Virales
9 Service d’Hépatologie [Hôpital Beaujon]
10 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
11 Inserm U1223 - Physiopathologie du système immunitaire
12 UPD5 - Université Paris Descartes - Paris 5
13 Département d'hépatologie [CHU Cochin]
14 Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB)
15 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
16 Hôpital Haut-Lévêque [CHU Bordeaux]
17 Institut Arnault Tzanck
18 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
19 Hôpital Avicenne [AP-HP]
20 C3M - Centre méditerranéen de médecine moléculaire
21 Département d'hépato-gastroentérologie
22 Service d'Hépato-Gastroentérologie [CHU Rouen]
23 CHU Angers - Centre Hospitalier Universitaire d'Angers
24 Pôle Maladies de l'appareil digestif [CHU Toulouse]
25 PHARMA-DEV - Pharmacochimie et Biologie pour le Développement
26 Service d'hépatologie et de gastroentérologie [Hôpital Saint-Joseph - Marseille]
27 Hôpital Claude Huriez [Lille]
28 LIRIC - Lille Inflammation Research International Center - U 995
29 Hôpital Saint-André
30 CHU Estaing [Clermont-Ferrand]
31 CHU Saint-Antoine [AP-HP]
32 Hôpital Henri Mondor
33 CHU Tenon [AP-HP]
34 Hôpital Paul Brousse
35 Département d'Hépato-Gastroentérologie [Hôpital Trousseau, Tours]
36 CHIAP - Centre Hospitalier d'Aix en Provence [Aix-en-Provence]
37 Service d'Hépato-Gastro-Enterologie et Nutrition [CHU Caen]
38 Centre Hospitalier Le Mans (CH Le Mans)
39 CHU de Poitiers - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
40 IMM - Institut Mutualiste de Montsouris
41 IMM - Institut mutualiste Monsouris
42 Hôpital universitaire Robert Debré [Reims]
43 Hôpital Foch [Suresnes]
44 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
Denis Ouzan
Fabien Zoulim
Jean-Pierre Bronowicki
  • Fonction : Auteur
Paul Calès
Armand Abergel
Lawrence Serfaty
Christos Christidis
David Zucman
Anrs Co12 Cirvir Group
  • Fonction : Auteur

Résumé

BACKGROUND: The objective was to examine the role of a sustained virological response (SVR) on major adverse cardiovascular events (MACEs) in patients with compensated hepatitis C virus (HCV) cirrhosis.

METHODS: Patients with the following criteria were enrolled in 35 French centers: (1) biopsy-proven HCV cirrhosis; (2) Child-Pugh A; (3) positive viremia; and (4) no prior liver complication, and then prospectively followed. All patients received HCV treatment after inclusion. MACEs included stroke, myocardial infarction, ischemic heart disease, heart failure, peripheral arterial disease, cardiac arrest, and cardiovascular death. SVR, defined as negative viremia 12 weeks posttreatment, was considered as a time-dependent covariate, and its effect on MACE occurrence was assessed. The median follow up was 57.5 months, ending in December 2015.

RESULTS: Sixty-two of 878 (7.1%) patients presented a total of 79 MACEs. The main predictive baseline factors of MACEs were Asian ethnic origin, history of MACEs, arterial hypertension, diabetes mellitus, current smoking, low serum albumin level, high total bilirubin level, and low platelet count. In multivariate analysis, SVR was associated with a decreased risk of MACEs (hazard ratio=0.35, 95% CI 0.09-0.97, P=.044), whereas Asian ethnic origin, arterial hypertension, smoking, and low serum albumin level remained predictive of MACE occurrence. The 5-year survival rate was 60.1% versus 87.5% in patients who did versus those who did not present a MACE (P<.001).

CONCLUSIONS: In patients with compensated HCV-related cirrhosis, Asian ethnic origin, arterial hypertension, smoking, and low serum albumin are independent predictive factors of cardiovascular events, whereas an SVR is associated with a decreased rate of cardiovascular events.

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Dates et versions

hal-02648446 , version 1 (29-05-2020)

Identifiants

Citer

Patrice Cacoub, Pierre Nahon, Richard Layese, Lorraine Blaise, Anne Claire Desbois, et al.. Prognostic value of viral eradication for major adverse cardiovascular events in hepatitis C cirrhotic patients. American Heart Journal, 2018, 198, pp.4-17. ⟨10.1016/j.ahj.2017.10.024⟩. ⟨hal-02648446⟩
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