6533b86efe1ef96bd12cc9e9
RESEARCH PRODUCT
Impact of direct acting antivirals (DAAs) on cardiovascular events in HCV cohort with pre-diabetes
Riccardo NevolaRosa LombardiCelestino SarduAntonio SolanoAntonio CraxìAnna Ludovica FracanzaniPia Clara PafundiTeresa SalvatoreRaffaele MarfellaFerdinando Carlo SassoAlessandro PerrellaMauro GiordanoErica VetranoAlfredo CaturanoLuigi Elio AdinolfiLuca RinaldiCarmine CoppolaSalvatore PettaRaffaele GalieroVito Di Marcosubject
MaleTime FactorsEndocrinology Diabetes and MetabolismCardiovascular risk Direct acting antiviralsHepatitis C virusPrediabetes Aged Antiviral Agents Cardiovascular Diseases FemaleHeart Disease Risk Factors Hepatitis C Humans Incidence Italy Longitudinal Studies Male Middle Aged Prediabetic State Prospective Studies Protective Factors Retrospective Studies Risk AssessmentTime Factors Treatment Outcome Viral LoadMedicine (miscellaneous)Type 2 diabetes030204 cardiovascular system & hematologymedicine.disease_causeDIRECT ACTING ANTIVIRALSLiver disease0302 clinical medicineLongitudinal StudiesProspective StudiesPrediabeteseducation.field_of_studyNutrition and DieteticsIncidenceMiddle AgedViral LoadHepatitis CTreatment OutcomeItalyCardiovascular DiseasesCohortFemaleCardiology and Cardiovascular Medicinemedicine.medical_specialtyHepatitis C virusPopulation030209 endocrinology & metabolismAntiviral AgentsRisk AssessmentPrediabetic State03 medical and health sciencesInternal medicinemedicineHumanseducationAgedRetrospective Studiesbusiness.industryProtective FactorsCardiovascular riskmedicine.diseaseHeart Disease Risk FactorsDirect acting antiviralHepatitis C virubusinessPrediabetesMacedescription
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. 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). 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.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-01-01 |