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ORIGINAL ARTICLE
Year : 2021  |  Volume : 34  |  Issue : 1  |  Page : 180-186

Assessment of coronary artery disease extension and severity in hepatitis C-infected patients


1 Department of Cardiology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Cardiology, Elzaytoun Hospital, Cairo, Egypt

Correspondence Address:
John R Nageh
Department of Cardiology, Elzaytoun Hospital, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mmj.mmj_259_19

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Objectives To assess extension and severity of coronary artery disease (CAD) in patients with hepatitis C viral infection. Background Chronic HCV infection causes hepatic and systemic inflammation via increased levels of proatherogenic chemokines and cytokines Patients and methods This prospective cohort study was conducted on 200 stable patients scheduled for elective coronary angiography. All patients were evaluated by history taking and clinical, coronary angiography, and laboratory investigations, and the severity of the coronary lesions was estimated using the Gensini score. Results There were statistically significant differences between both groups regarding the presence of ischemic ST-T changes, where 38 patients of group A had those changes, whereas 67 patients of group B had them (P = 0.009). There was a statistically significant difference between both groups regarding ejection fraction% and segmental wall motion abnormalities. Overall, 78% of hepatitis C virus (HCV)-positive patients had significant CAD (group A) compared with 60% of patients with HCV negative (group B), with P = 0.006. Moreover, one-vessel affection was mainly among HCV-negative patients (55%) versus 34.6% in HCV-positive patients, with significant difference between both group (P = 0.003). Moreover, there was a statistically significant positive correlation between CAD severity according to Gensini score and HCV seropositivity (Gensini score in group A was 46.9 ± 53.7 vs. 17.9 ± 28.1 in group B; P < 0.001). Conclusion We have demonstrated an association between HCV infection and the severity of coronary atherosclerosis assessed with Gensini score, and the proposed mechanism was exaggerated inflammation in response to hepatitis virus infection.


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