Hepatitis C virus infection as a risk factor for increased aortic stiffness and cardiovascular events in dialysis patients.
BACKGROUND
Although links have been found between microorganisms and cardiovascular diseases, the role of hepatitis C virus (HCV) infection in the pathogenesis of arteriosclerosis and cardiovascular events is unclear. The primary objective of this research was to examine whether HCV infection is associated with increased aortic stiffness and cardiovascular events in chronic hemodialysis patients.


METHODS
A prospective cohort study was conducted in 94 dialysis outpatients from October 2002 to October 2004. Measurements included carotid-femoral pulse wave velocity (PWV), echocardiographic parameters, serum HCV-RNA (positive in 17 patients), and several items of biochemical data. Multiple logistic regression and the Cox proportional hazard model were used to assess independent determinants of high aortic PWV (> or =10.0 m/sec, mean) and cardiovascular events (including cerebral and peripheral vascular events), adjusting for several risk factors and duration of dialysis.


RESULTS
The HCV-positive group had higher aortic PWV and lower serum cholesterol levels. Multivariate analysis indicated mean blood pressure, hemoglobin A1c and HCV viremia to be independent determinants of high PWV. During the follow-up period, 13 patients suffered from cardiovascular events. Prevalence of the diseases at baseline, pulse pressure, left ventricular mass index, HCV viremia and aortic PWV were associated with cardiovascular events. The Kaplan-Meier analysis indicated a significant difference in event-free rates between HCV-positive and HCV-negative patients.


CONCLUSIONS
HCV infection is closely associated with increased aortic stiffness and cardiovascular event in dialysis patients.
Oyake
Nobuyuki
N
Division of Cardiovascular Medicine, Department of Internal Medicine, Faculty of Medicine, Shimane University, Izumo, Shimane, Japan.
Shimada
Toshio
T
Murakami
Yo
Y
Ishibashi
Yutaka
Y
Satoh
Hidetoshi
H
Suzuki
Keiko
K
Matsumory
Akira
A
Oda
Teiji
T
D000368:Aged; D001011:Aorta / Q000503:physiopathology*; D001783:Blood Flow Velocity; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology / Q000821:virology*; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy / Q000821:virology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011673:Pulsatile Flow; D006435:Renal Dialysis; D012307:Risk Factors; D016019:Survival Analysis