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

Patrice Cacoub 1, 2, 3 Pierre Nahon 4, 5, 6 Richard Layese 7, 8 Lorraine Blaise 4 Anne Desbois 1, 2, 3 Valérie Bourcier 4 Carole Cagnot 9 Patrick Marcellin 10 Dominique Guyader 11 Stanislas Pol 12, 13, 14 Dominique Larrey 15 Victor de Ledinghen 16 Denis Ouzan 17 Fabien Zoulim 18 Dominique Roulot 19 Albert Tran 20 Jean-Pierre Bronowicki 21 Jean-Pierre Zarski 22 Ghassan Riachi 23 P. 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 6, 47, 48 Angela Sutton 47, 48 Eric Letouze 6 Françoise Roudot-Thoraval 8, 7 Etienne Audureau 7, 8
5 Equipe labellisée Ligue Contre le Cancer [Saint-Denis]
UP13 - Université Paris 13, PRES Sorbonne Paris Cité
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.

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https://hal.univ-angers.fr/hal-02648446
Contributeur : Okina Université d'Angers <>
Soumis le : vendredi 29 mai 2020 - 09:35:50
Dernière modification le : vendredi 16 octobre 2020 - 03:09:36

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

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