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Impact of direct acting antivirals (DAAs) on cardiovascular events in HCV cohort with pre-diabetes.
- Source :
-
Nutrition, metabolism, and cardiovascular diseases : NMCD [Nutr Metab Cardiovasc Dis] 2021 Jul 22; Vol. 31 (8), pp. 2345-2353. Date of Electronic Publication: 2021 May 01. - Publication Year :
- 2021
-
Abstract
- Background and Aims: Beyond type 2 diabetes, even a condition of prediabetes is associated with an increased cardiovascular (CV) risk, and HCV infection coexistence represents an exacerbating factor. CV prognosis improvement in prediabetes represents a challenge, due to the increasing prevalence of this metabolic condition worldwide. Hence, we aimed to prospectively assess how direct acting antivirals (DAAs) could affect major cardiovascular events (MACE) in a prediabetic HCV positive cohort.<br />Methods and Results: In this prospective multicenter study, we enrolled HCV patients with overt prediabetes. We compared a subgroup of patients treated with DAAs with untreated prediabetic controls. We recorded all CV events occurred during an overall median follow-up of 24 months (IQR 19-34). 770 HCV positive prediabetic patients were enrolled, 398 untreated controls and 372 DAAs treated patients. Overall, the CV events annual incidence was much higher among prediabetic treated patients (1.77 vs. 0.62, p < 0.001), and HCV clearance demonstrated to significantly reduce CV events (RR: 0.411, 95%CI 0.148-1.143; p < 0.001), with an estimated NNT for one additional patient to benefit of 52.1. Moreover, an independent association between a lower rate of CV events and HCV clearance after DAAs was observed (OR 4.67; 95%CI 0.44-53.95; p = 0.016).<br />Conclusions: HCV eradication by DAAs allows a significant reduction of MACEs in the prediabetic population, and therefore represents a primary objective, regardless of the severity of liver disease and CV risk factors.<br />Competing Interests: Declaration of competing interest The authors declare no conflict of interest.<br /> (Copyright © 2021 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Aged
Antiviral Agents adverse effects
Cardiovascular Diseases diagnosis
Cardiovascular Diseases epidemiology
Female
Heart Disease Risk Factors
Hepatitis C diagnosis
Hepatitis C epidemiology
Humans
Incidence
Italy epidemiology
Longitudinal Studies
Male
Middle Aged
Prediabetic State diagnosis
Prospective Studies
Protective Factors
Retrospective Studies
Risk Assessment
Time Factors
Treatment Outcome
Viral Load
Antiviral Agents therapeutic use
Cardiovascular Diseases prevention & control
Hepatitis C drug therapy
Prediabetic State epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1590-3729
- Volume :
- 31
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Nutrition, metabolism, and cardiovascular diseases : NMCD
- Publication Type :
- Academic Journal
- Accession number :
- 34053830
- Full Text :
- https://doi.org/10.1016/j.numecd.2021.04.016