Association Between Past Hepatitis B Infection and Ischemic Heart Disease: An Analysis From the 2007-2016 NHANES Data

Infection is postulated as a possible risk factor for ischemic heart disease with a spiralling body of evidence. Hepatitis B is one of the most comprehensively investigated infection for its association with ischemic heart disease. This study aims at establishing an association between Hepatitis B core antibody status and ischemic heart disease using National Health and Nutrition Examination Survey (NHANES) database.

NHANES data from 2007 to 2016 were used for the present analysis. To identify patients with self-reported coronary heart disease, angina/angina pectoris, myocardial infarction, we examined the answers to questions MCQ160c, MCQ160d, MCQ160e delineated in NHANES data. These questions as described in the NHANES dataset are as follows: MCQ160c-Has a doctor or other health professional ever told you that you had coronary heart disease?, MCQ160d-Has a doctor or other health professional ever told you that you had angina, also called angina pectoris?, MCQ160e- Has a doctor or other health professional ever told you that you had a heart attack also called myocardial infarction?. Next, to identify patients with positive Hepatitis B core antibody, we examined the variable LBXHBC of the NHANES dataset. Baseline characteristics, along with unadjusted and adjusted odds ratio using multivariable logistic regression analysis, of included patients were analyzed for Hepatitis B core antibody and its association with ischemic heart disease.

A total of 3,248 individuals with ischemic heart disease and 42,345 individuals with no ischemic heart disease were included in the final analysis. Hepatitis B core antibody positive status was associated with lower incidence of ischemic heart disease, adjusted odds ratio of 0.61 (95% confidence interval: 0.41-0.92, P value < 0.02).

In conclusion, the present analysis points toward a possible association between past Hepatitis B infection and ischemic heart disease. Hepatitis B infection was associated with a decreased incidence of ischemic heart disease. Further research with better design and possible molecular mechanism is warranted.