title: Hepatitis C virus infection and coronary artery disease risk: a systematic review of the literature.
abstract: OBJECTIVE
  While hepatitis C virus (HCV) infection has been implicated in increasing the risk of coronary artery disease (CAD), conflicting reports exist regarding this association. We performed a systematic review to further investigate this association.
  
  
  METHODS
  We conducted a PubMed search of original research articles from January 1, 1995 to June 30, 2013 to identify case-control and cohort studies evaluating the association between HCV and CAD using keyword terms ["hepatitis c" or "HCV"] and ["coronary artery disease" or "heart disease" or "atherosclerosis."] The primary CAD-related endpoints included myocardial infarction, congestive heart failure, need for coronary artery bypass grafting, or transluminal percutaneous coronary angioplasty. Binary outcomes are reported as odds ratios (OR) with 95 % confidence interval (CI).
  
  
  RESULTS
  We identified five studies (four cohort studies and one case-control study) that met our inclusion criteria. A significant association between HCV and CAD was demonstrated in one cohort study (adjusted HR 1.27; 95 % CI 1.22-1.31). One cohort study demonstrated a decreased risk of CAD associated with HCV (adjusted OR 0.74; 95 % CI 0.71-0.76). The remaining studies did not find a significant association between HCV and risk of CAD.
  
  
  CONCLUSIONS
  The current systematic review demonstrates that the association between HCV and CAD remains unclear. We need more large, long-term cohort studies with clear definitions of patient population and endpoints to better ascertain the association between HCV and CAD.
authors.affiliation: Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA, rwong123@stanford.edu.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Wong
authors.forename: Fasiha
authors.initials: F
authors.lastname: Kanwal
authors.forename: Zobair M
authors.initials: ZM
authors.lastname: Younossi
authors.forename: Aijaz
authors.initials: A
authors.lastname: Ahmed
mesh_terms: D050197:Atherosclerosis / Q000821:virology; D003324:Coronary Artery Disease / Q000821:virology*; D006333:Heart Failure / Q000821:virology; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D009203:Myocardial Infarction / Q000821:virology; D012307:Risk Factors