Prevalence of Hepatitis C Virus Seropositivity and Its Impact on Coronary Artery Disease among Egyptian Patients Referred for Coronary Angiography

Abstract

Background. We tested the prevalence and impact of HCV seropositivity among Egyptian patients referred for coronary angiography. Subjects and Methods. This cross-sectional study was conducted in Zagazig University hospitals including 509 patients scheduled for elective coronary angiography between June 2013 and June 2014. By taking full history on admission, laboratory workup including HCV Ab, echocardiography study, and coronary angiography, we calculated the mean number of coronary artery lesions and the mean number of affected coronary artery vessels for all patients. The severity of the coronary lesions was estimated using the Gensini score. Results. HCV seropositive patients referred for coronary angiography were about 30.3% (which is greater than the prevalence of HCV seropositivity among general population in Egypt), patients proved to have CAD who are HCV antibody positive had more severe coronary lesions than in seronegative one (p < 0.05), and patients proved to have CAD who are HCV antibody positive had comparable prevalence of cardiovascular risk factors as seronegative patients except for diabetes and hypertension which are more prevalent in seronegative patients (p < 0.05). Conclusion. Prevalence of HCV antibody positive patients referred for coronary angiography was about 30.3%, and CAD patients who are HCV antibody positive had more severe coronary lesions and less prevalence of diabetes and hypertension than HCV antibody negative.

Risk of Cardiovascular Disease Due to Chronic Hepatitis C Infection: A Review

“…The preponderance of the data suggests an increased risk for the development of coronary artery atherosclerosis as well as an increase in the severity of CAD based on the majority of case-control studies in which HCV-infected patients underwent coronary angiography. 11 , 51 – 53 , 63 , 64 , 66 However, it is uncertain whether the likely increased risk of coronary atherosclerosis translates to an increased risk of MI among these patients since many studies were unable to demonstrate an association between HCV infection and rates of MI. For example in the study by Forde et al , 58 HCV infection did not increase the risk of MI but the mean follow-up period was only 3.2 years, which may have limited the ability to detect an association given the chronic nature of atherosclerosis and the cumulative risk that eventually leads to the sentinel clinical event of MI.…”

“… 11 In patients undergoing coronary angiography for evaluation of CAD, Satapathy et al 63 observed a significantly higher prevalence of CAD (69.8% vs. 47.6%, p = 0.01), significantly higher modified Reardon’s severity scores (6.26 ± 5.39 vs. 2.6 ± 3.03, p < 0.0005), and significant multivessel CAD (defined as >50% stenosis in ≥2 vessels involved; 57.1% vs. 15.9%, p < 0.0005) among the HCV-infected patients compared to controls. Salam et al 64 reported that HCV antibody-positive patients had more severe coronary lesions than seronegative patients among those referred for angiography. Unlike the previous studies, Pothineni et al 65 found no significant differences between HCV-infected patients and controls in the number of vessels with obstructive coronary disease, and there was no correlation between HCV RNA titers and severity of CAD as assessed by the Gensini score ( p = 0.90).…”

Acute Coronary Syndrome in Patient with Viral Hepatitis C: An Underdiagnosed Condition in Sub-Saharan Africa

“…But from the localization of the ST elevation and the akinetic segment on the ultrasonography, we suppose that the stenosis must concern the anterior interventricular branch of the left coronary artery. Salam et al found that the prevalence of VHC antibodies positivity in a group of Egyptians in 2014 was significantly higher in the group of patients proved angiographically to have coronary heart disease than the control group without ischemia [17]. Considering all these reasons we can strongly presume that our patient has developed ischemic events due to VHC.…”

“…VHC seropositivity is considered to be an independent predictor for increased coronary atherosclerosis [13][14][15]. This can be illustrated by the presence of genomic and antigenomic VHC RNA strands within carotid plaque tissues in most VHC-infected patients [17] and by the proinflammatory and profibrogenic environment prompting fibrogenesis in the liver and in the whole cardiovascular system [13]. But theses hypotheses are still debated sincesome authors have found normal prevalence of carotid artery plaques in patients with HVC compared with control populations [16].…”

Acute Coronary Syndrome Occurring in a Sub-Saharan Patient Treated with a Reduced Dose of Sorafenib for an Unresectable Hepatocellular Carcinoma: Case Report

“…We can't miss out the fact that chronic liver disease which led to cirrhosis and hepatocellular carcinoma was induced by infection with the hepatitis C virus. A chronic infection by the hepatitis C virus can lead to some systemic manifestations which include heart affections without any cancer [14] [15] [16]. It is a potential risk factor for myocardial infarction in our patient independently of sorafenib.…”