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Cardiovascular events in chronic hepatitis C: prognostic value of liver stiffness evolution

Laura Serres1, Philippe Vasseur, David Tougeron

  • 1aHepatology and Gastroenterology Unit, University Hospital bLaboratoire Inflammation, Tissus Epithéliaux et Cytokines, Pôle Biologie Santé, Poitiers University, Poitiers, France.

European Journal of Gastroenterology & Hepatology
|August 15, 2015
PubMed

Insights

In chronic hepatitis C patients, high initial liver stiffness (≥7 kPa) measured by FibroScan is linked to increased cardiovascular events. Rapid progression of liver stiffness did not show a significant association with these events.

Area of Science:

  • Hepatology
  • Cardiology
  • Metabolic Diseases

Background:

  • Chronic hepatitis C is increasingly recognized as a metabolic disease associated with elevated cardiovascular event risk.
  • FibroScan is a valuable tool for assessing liver fibrosis and predicting cirrhosis complications and mortality.
  • Understanding the prognostic implications of liver stiffness in cardiovascular health is crucial for patient management.

Purpose of the Study:

  • To investigate the prognostic value of liver stiffness evolution and initial stiffness in predicting cardiovascular events in patients with chronic hepatitis C.
  • To determine if changes in liver stiffness over time or baseline stiffness levels correlate with cardiovascular outcomes.
  • To explore the relationship between liver stiffness parameters and the occurrence of myocardial infarctions and strokes in this patient cohort.

Main Methods:

  • A retrospective study included 135 patients with chronic hepatitis C who had two valid FibroScan measurements between 2006 and 2013.
  • Liver stiffness was measured using FibroScan, with 'rapid stiffness progression' defined as ≥0.3 kPa/year and 'high initial stiffness' as ≥7 kPa.
  • Cardiovascular events, including myocardial infarctions and strokes, were collected retrospectively following the initial FibroScan measurement.

Main Results:

  • Among 135 patients (mean follow-up 5.2 years), 7 experienced cardiovascular events.
  • Patients with high initial stiffness (≥7 kPa) had a significantly higher incidence of cardiovascular events (11%) compared to those with low initial stiffness (1%, P=0.04).
  • Rapid stiffness progression (≥0.3 kPa/year) was not significantly associated with an increased risk of cardiovascular events (6% vs. 5%, P=1.0).

Conclusions:

  • Initial liver stiffness of at least 7 kPa, as measured by FibroScan, is a significant predictor of cardiovascular events in patients with chronic hepatitis C.
  • The rate of liver stiffness progression does not appear to be a significant prognostic factor for cardiovascular events in this population.
  • These findings highlight the importance of baseline liver stiffness assessment for cardiovascular risk stratification in chronic hepatitis C patients.
Abstract

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