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

Patrice Cacoub; Pierre Nahon; Richard Layese; Lorraine Blaise; Anne Desbois; Valérie Bourcier; Carole Cagnot; Patrick Marcellin; Dominique Guyader; Stanislas Pol; Dominique Larrey; Victor de Ledinghen; Denis Ouzan; Fabien Zoulim; Dominique Roulot; Albert Tran; Jean-Pierre Bronowicki; Jean-Pierre Zarski; Ghassan Riachi; Paul Calès; Jean-Marie Péron; Laurent Alric; Marc Bourlière; Philippe Mathurin; Jean-Frédéric Blanc; Armand Abergel; Lawrence Serfaty; Ariane Mallat; Jean-Didier Grangé; Pierre Attali; Yannick Bacq; Claire Wartelle; Thong Dao; Dominique Thabut; Christophe Pilette; Christine Silvain; Christos Christidis; Dominique Capron; Gérard Thiefin; David Zucman; Vincent Di Martino; Corinne Isnard Bagnis; Marianne Ziol; Angela Sutton; Eric Letouze; Françoise Roudot-Thoraval; Etienne Audureau; Anrs Co12 Cirvir Group

doi:10.1016/j.ahj.2017.10.024

Article dans une revue

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

Patrice Cacoub ^{1, 2, 3} Pierre Nahon ^{4, 5} Richard Layese ^{6, 7} Lorraine Blaise ⁵ Anne Desbois ^{1, 2, 3} Valérie Bourcier ^{5, 8} Carole Cagnot ⁹ Patrick Marcellin ¹⁰ Dominique Guyader ¹¹ Stanislas Pol ^{12, 13, 14} Dominique Larrey ^{15, 16} Victor de Ledinghen ¹⁷ Denis Ouzan ¹⁸ Fabien Zoulim ¹⁹ Dominique Roulot ²⁰ Albert Tran ²¹ Jean-Pierre Bronowicki Jean-Pierre Zarski ²² Ghassan Riachi ²³ Paul Calès ²⁴ Jean-Marie Péron ²⁵ Laurent Alric ²⁶ Marc Bourlière ²⁷ Philippe Mathurin ²⁸ Jean-Frédéric Blanc ²⁹ Armand Abergel ³⁰ Lawrence Serfaty ³¹ Ariane Mallat ³² Jean-Didier Grangé ³³ Pierre Attali ³⁴ Yannick Bacq ³⁵ Claire Wartelle ³⁶ Thong Dao ³⁷ Dominique Thabut ^{38, 1} Christophe Pilette ³⁹ Christine Silvain ⁴⁰ Christos Christidis ⁴¹ Dominique Capron ⁴² Gérard Thiefin ⁴³ David Zucman ⁴⁴ Vincent Di Martino ⁴⁵ Corinne Isnard Bagnis ^{1, 46} Marianne Ziol ^{4, 5} Angela Sutton ⁵ Eric Letouze ⁴ Françoise Roudot-Thoraval ^{7, 6} Etienne Audureau ^{6, 7} Anrs Co12 Cirvir Group

1 DHU - I2B - Departement Hospitalo- Universitaire - Inflammation, Immunopathologie, Biothérapie [Paris]

2 I3 - Immunologie - Immunopathologie - Immunothérapie

3 DMIIC - Service de Département de médecine interne et immunologie clinique [CHU Pitié-Salpêtrière]

4 U1162 - Génomique Fonctionnelle des Tumeurs Solides

5 Hôpital Jean Verdier [AP-HP]

6 CEpiA - Clinical Epidemiology and Ageing : Geriatrie Soins Primaires et Santé Publique

7 Pôle Recherche Clinique-Santé Publique [Mondor]

8 USPN UP13 UFR SC - Université Sorbonne Paris Nord - UFR des Sciences de la communication

9 ANRS - Agence Nationale de Recherches sur le Sida et les Hépatites Virales

10 Service d’Hépatologie [Hôpital Beaujon]

11 CHU Pontchaillou [Rennes]

12 Inserm U1223 - Physiopathologie du système immunitaire

13 UPD5 - Université Paris Descartes - Paris 5

14 Département d'hépatologie [CHU Cochin]

15 Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB)

16 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]

17 Hôpital Haut-Lévêque [CHU Bordeaux]

18 Institut Arnault Tzanck

19 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]

20 Hôpital Avicenne [AP-HP]

21 C3M - Centre méditerranéen de médecine moléculaire

22 Département d'hépato-gastroentérologie

23 Service d'Hépato-Gastroentérologie [CHU Rouen]

24 CHU Angers - Centre Hospitalier Universitaire d'Angers

25 Service de Gastro-entérologie - Hépatologie [Purpan]

26 PHARMA-DEV - Pharmacochimie et Biologie pour le Développement

27 Service d'hépatologie et de gastroentérologie [Hôpital Saint-Joseph - Marseille]

28 Hôpital Claude Huriez [Lille]

29 Hôpital Saint-André

30 CHU Estaing [Clermont-Ferrand]

31 Service d'Hépato-gastro-entérologie [CHU Saint-Antoine]

32 Hôpital Henri Mondor

33 CHU Tenon [AP-HP]

34 Hôpital Paul Brousse

35 Département d'hépato-gastro-entérologie [Hôpital Trousseau : CHRU Tours]

36 CHIAP - Centre Hospitalier d'Aix en Provence [Aix-en-Provence]

37 Service d'Hépato-Gastro-Enterologie et Nutrition [CHU Caen]

38 Service d'Hépato-Gastro-Entérologie [CHU Pitié-Salpêtrière]

39 Centre Hospitalier Le Mans (CH Le Mans)

40 CHU Poitiers - Centre hospitalier universitaire de Poitiers

41 IMM - Institut Mutualiste de Montsouris

42 IMM - Institut mutualiste Monsouris

43 CHU Reims - Centre Hospitalier Universitaire de Reims

44 Hôpital Foch [Suresnes]

45 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon

46 Service de Néphrologie [CHU Pitié-Salpêtrière]

Abstract :

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.

Keywords : Biopsy Antiviral Agents Severity of Illness Index Survival rate Sex Distribution Risk Assessment Retrospective Studies Predictive Value of Tests Middle Aged Male Liver Function Tests Liver Cirrhosis Kaplan-Meier Estimate Immunohistochemistry Humans Chronic Hepatitis C France Female Cohort Studies Cardiovascular Diseases Age Distribution Prevalence Proportional Hazards Models Prognosis Needle Aged

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Sciences du Vivant [q-bio]

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https://hal.univ-angers.fr/hal-02648446
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Soumis le : vendredi 29 mai 2020 - 09:35:50
Dernière modification le : vendredi 20 mai 2022 - 11:06:54

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

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