title: Association of hepatitis C virus seropositivity with inflammatory markers and heart failure in persons with coronary heart disease: data from the Heart and Soul study.
abstract: BACKGROUND
  How hepatitis C virus (HCV) affects coronary heart disease (CHD) risk factors and outcomes is largely unknown.
  
  
  RESULTS
  Among a cohort of patients with stable CHD, we examined the association between HCV seropositivity and levels of inflammatory markers (C-reactive protein [CRP], fibrinogen, interleukin-6, and tumor necrosis factor [TNF]-alpha) and risk for the following outcomes: death, cardiovascular (CV) events, and heart failure events. A total of 84 (8.6%) participants were found to be seropositive for HCV. HCV-seropositive patients were found to have significantly lower adjusted mean levels of CRP (2.6 vs. 4.4; P < .01) and fibrinogen (340 vs. 398; P < .01), but higher levels of TNF-alpha (7.1 vs. 4.8; P < .01). Age-adjusted rates for HCV seropositive vs. seronegative were as follows: death 93 vs. 42/1,000p-y (P < .01), CV events 62 vs. 40 (P=.13), and heart failure 76 vs. 29 (P < .01). After adjustment for demographic and clinical factors, HCV remained significantly associated with an increased risk for heart failure events (HR=2.13; 95% CI: 1.19-3.80).
  
  
  CONCLUSIONS
  In this cohort with CHD, HCV seropositive participants had higher rates of death, CV events, and heart failure hospitalizations during follow-up. After adjustment for CV risk factors, HCV seropositivity remained independently associated with risk for heart failure events.
authors.affiliation: Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine/Boston Medical Center, Boston, MA 02118, USA. judith.tsui@gmail.com
authors.forename: Judith I
authors.initials: JI
authors.lastname: Tsui
authors.forename: Mary A
authors.initials: MA
authors.lastname: Whooley
authors.forename: Alexander
authors.initials: A
authors.lastname: Monto
authors.forename: Karen
authors.initials: K
authors.lastname: Seal
authors.forename: Phyllis C
authors.initials: PC
authors.lastname: Tien
authors.forename: Michael
authors.initials: M
authors.lastname: Shlipak
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D003327:Coronary Disease / Q000097:blood / Q000150:complications* / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D054144:Heart Failure, Diastolic / Q000097:blood* / Q000209:etiology; D016174:Hepacivirus / Q000276:immunology*; D018937:Hepatitis C Antibodies / Q000032:analysis*; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000821:virology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D018937:Hepatitis C Antibodies; D002097:C-Reactive Protein