Higher Prevalence and More Severe Coronary Artery Disease in Hepatitis C Virus-infected Patients: A Case Control Study

Background: An association of Coronary artery disease (CAD) with hepatitis C (HCV) has been suggested, but definitive data are still lacking. Aim: Our study sought to estimate the prevalence and severity of CAD in HCV patients compared to with age-, sex-, and race-matched controls without HCV infection. Subjects and methods: 63 HCV-infected patients were compared with 63 age, race, and sex-matched controls without HCV infection undergoing coronary angiography for evaluation of CAD. CAD was defined as more than a 50% blockage in any of the proximal coronary arteries on angiogram. The severity of the stenosis was defined by the modified Reardon severity scoring system: <50% stenosis of the luminal diameter, 1 point; 50-74%, 2 points; 75-99%, 3 points; 100% or total obstruction, 4 points. The points for each lesion in the proximal coronary circulation were summed to give the score for severity. Results: A significantly higher prevalence of CAD was noted in the HCV population (69.8% vs. 47.6%,=0.01). The combined Reardon's severity score in the HCV group was significantly higher compared to the controls (6.26±5.39 vs. 2.6±3.03, P<0.0005). Additionally, significant multivessel CAD (>50% stenosis and ≥2 vessels involved) was also noted significantly more commonly in the HCV group compared to controls (57.1% vs. 15.9%, P<0.0005). Conclusion: In this retrospective study the prevalence andseverity of CAD was higher in HCV patients who were evaluated for CAD by angiogram compared with matched non-HCV patients. HCV-positive status is potentially a risk factor for CAD.