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The impact of chronic hepatitis B infection on major adverse cardiovascular events and all-cause mortality in patients with diabetes: a nationwide population-based study from Taiwan.


ABSTRACT:

Objectives

The association between hepatitis B virus (HBV) infection and cardiovascular disease remains uncertain. This study explored long-term hard endpoints (ie, myocardial infarction and ischaemic stroke) and all-cause mortality in diabetic patients with chronic HBV infection in Taiwan from 2000 to 2013.

Design

This study was retrospective, longitudinal and propensity score-matched.Setting Nationwide claims data for the period 2000-2013 were retrieved from Taiwan's National Health Insurance Research Database.

Participants

The study included 40?162 diabetic patients with chronic HBV infection (HBV cohort) and 40?162 propensity score-matched diabetic patients without HBV infection (control cohort). Chronic HBV infection was identified based on three or more outpatient clinic visits or one hospital admission with a diagnosis of HBV infection.

Main outcome measures

Primary outcomes were major adverse cardiovascular events (MACE, including myocardial infarction and ischaemic stroke), heart failure and all-cause mortality.

Results

During the median follow-up period of 5.3±3.4 years, the HBV cohort had significantly lower risks of myocardial infarction (adjusted HR (aHR)=0.49; 95% CI 0.42 to 0.56), ischaemic stroke (aHR=0.61; 95%?CI 0.56 to 0.67), heart failure (aHR=0.50; 95%?CI 0.43 to 0.59) and all-cause mortality (aHR=0.72; 95%?CI 0.70 to 0.75) compared with the control cohort. The impact of HBV infection on the sequential risk of MACE was greater in patients with fewer diabetic complications.

Conclusions

Chronic HBV infection was associated with decreased risk of MACE, heart failure and all-cause mortality in patients with diabetes. Further research is needed to investigate the mechanism underlying these findings.

SUBMITTER: Kuo CS 

PROVIDER: S-EPMC5629723 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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Publications

The impact of chronic hepatitis B infection on major adverse cardiovascular events and all-cause mortality in patients with diabetes: a nationwide population-based study from Taiwan.

Kuo Chin-Sung CS   Chen Yung-Tai YT   Hsu Chien-Yi CY   Chang Chun-Chin CC   Chou Ruey-Hsing RH   Li Szu-Yuan SY   Kuo Shu-Chen SC   Huang Po-Hsun PH   Chen Jaw-Wen JW   Lin Shing-Jong SJ  

BMJ open 20170821 8


<h4>Objectives</h4>The association between hepatitis B virus (HBV) infection and cardiovascular disease remains uncertain. This study explored long-term hard endpoints (ie, myocardial infarction and ischaemic stroke) and all-cause mortality in diabetic patients with chronic HBV infection in Taiwan from 2000 to 2013.<h4>Design</h4>This study was retrospective, longitudinal and propensity score-matched.Setting Nationwide claims data for the period 2000-2013 were retrieved from Taiwan's National He  ...[more]

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