Lipid Levels and the Risk of Acute Myocardial Infarction Among HCV Infected and
Background: HCV infected persons have lower total cholesterol and LDL levels compared to demographically similar HCV uninfected persons. Whether this is associated with a lower risk of acute myocardial infarction (AMI) is unknown.
Methods: We used ERCHIVES to identify confirmed HCV+ and HCV- persons with low risk of AMI, by excluding those with diabetes, hypertension, chronic kidney disease, smoking and COPD. We also excluded those with baseline CVD, HIV, females (due to small numbers), and those who received HCV treatment. AMI was diagnosed based on previously established ICD-9 codes. We compared AMI rates among lipid strata based on NCEP defined lipid strata.
Results: We identified 55,814 HCV+ (median age 53; median BMI 26.7) and 84,772 HCV- (median age 52, median BMI 28.3) persons. There were 4,924 AMI events in the HCV+ and 8,888 events in the HCV- group. For matched total cholesterol (TC) and LDL strata above optimal levels (TC <200; LDL <100; TG <150 mg/dl), AMI rates were higher among HCV+ vs. HCV- persons. Among those with TC≥240mg/dl, AMI rates/1,000 patient years of follow up (95% CI) was 5.13 (4.2,6.0) for HCV+, vs. 4.35 (3.9,4.8) for HCV- persons. For LDL≥190mg/dl, rates were 7.02 (4.8,9.2) for HCV+ and 5.13 (4.2,6.1) for HCV- persons. Among HCV+ persons, the increase in hazards of AMI with higher TC and LDL strata was greater than that seen among HCV- persons
Conclusion: HCV+ persons have higher rates of AMI at similar TC and LDL levels compared with HCV- persons. The difference in risk at higher strata compared with optimal levels is numerically larger among HCV+ persons.
K. Chew, None
J. Currier, None
K. Corey, None
R. T. Chung, None
J. Butler, None
M. Freiberg, None