Impact of hepatitis C virus infection on long-term mortality after acute myocardial infarction: a nationwide population-based, propensity-matched cohort study in Taiwan.

Abstract

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.

• Authors: Shu-Hung Kuo, Wang-Ting Hung, Pei-Ling Tang, Wei-Chun Huang, Jin-Shiou Yang, Hsiao-Chin Lin, Guang-Yuan Mar, Hong-Tai Chang, Chun-Peng Liu
• Journal: BMJ open (BMJ Open) Vol. 8 Issue 1 Pg. e017412 (01 26 2018) ISSN: 2044-6055 [Electronic] England
• PMID: 29374659 (Publication Type: Journal Article)
• Copyright: © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Topics

• Acute Disease
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Cohort Studies
• Female
• Hepatitis C, Chronic (complications, epidemiology)
• Humans
• Liver Cirrhosis (complications)
• Male
• Middle Aged
• Myocardial Infarction (mortality)
• Risk Factors
• Survival Analysis
• Taiwan (epidemiology)
• Time Factors
• Young Adult