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Association Between Hepatitis C Virus Infection and SYNTAX Score in Patients with ST-Segment Elevation Myocardial
Ismail Balaban1, Seda Tanyeri Uzel1, Elif Caglayan2
1Department of Cardiology, Hamidiye School of Medicine, Kosuyolu Heart, Education and Research Institute, University of Health Sciences, Istanbul 34865, Turkey.
Journal of Clinical Medicine
|June 12, 2026
Summary
Chronic hepatitis C virus (HCV) infection is linked to more complex coronary artery disease in ST-elevation myocardial infarction (STEMI) patients. This association suggests HCV is a cardiovascular risk factor influencing atherosclerosis, but not short-term mortality.
Area of Science:
- Cardiology
- Hepatology
- Vascular Biology
Background:
- Chronic hepatitis C virus (HCV) infection is a systemic inflammatory condition linked to accelerated atherosclerosis and cardiovascular events.
- The relationship between HCV infection and coronary anatomical complexity in ST-segment elevation myocardial infarction (STEMI) patients is not well-defined.
Purpose of the Study:
- To assess the association between chronic HCV infection and coronary artery disease complexity (SYNTAX score) in STEMI patients undergoing primary percutaneous coronary intervention (pPCI).
- To investigate the relationship between HCV infection and in-hospital mortality in this patient group.
Main Methods:
- Retrospective analysis of 1647 STEMI patients treated with pPCI.
- Comparison of 106 HCV-positive patients with 105 propensity score-matched HCV-negative controls.
- Primary endpoint: SYNTAX score. Secondary endpoint: in-hospital all-cause mortality.
Main Results:
- HCV-positive patients had significantly higher SYNTAX scores, indicating greater coronary anatomical complexity, both before and after matching (p < 0.001 and p = 0.002, respectively).
- Coronary artery bypass grafting referral was more frequent in HCV-positive patients (p = 0.010 and p = 0.016).
- HCV positivity was independently associated with higher SYNTAX scores but not with in-hospital mortality.
Conclusions:
- Chronic HCV infection is independently associated with increased coronary anatomical complexity in STEMI patients undergoing pPCI.
- This suggests HCV infection contributes to a more diffuse and complex atherosclerotic phenotype, acting as a non-traditional cardiovascular risk factor.
- HCV infection did not appear to influence short-term in-hospital mortality in this cohort.
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