Risk of cardiac arrhythmias in patients with chronic hepatitis B and C infections - A 13-year nationwide population-based study.
BACKGROUND
Chronic hepatitis C virus (HCV) infection is associated with higher risk of cardiovascular events than chronic hepatitis B virus (HBV). We aimed to investigate whether there is higher risk of arrhythmia in HCV infection.


METHODS
Electronic medical records from National Health Institute Research Database during 2000-2012 were retrieved for patients with HBV or HCV. Patients with missing information, aged <18 years, diagnosed with HBV or HCV before year 2000, concomitant HBV and HCV, coagulopathy or organ transplant, history of arrhythmia, device implantation, congenital heart disease, rheumatic heart disease, hypertrophic cardiomyopathy, thyroid disease, alcohol or drug abuse, valvular heart disease, or follow-up <6 months were excluded. Primary outcomes were cardiac arrhythmias and all-cause mortality.


RESULTS
After 1:1 propensity score matching, 5480 patients with HBV and 5480 patients with HCV were included for study. During a mean follow-up of 6.5 years, the risk of all-cause mortality was higher in the HCV patients than in HBV patients [hazard ratio (HR) 1.35, 95% confidence interval (CI) 1.16-1.58]. There was also a trend toward higher incidence of atrial fibrillation (HR 1.25, 95% 0.98-1.59, p=0.070) and a significantly higher incidence of sick sinus syndrome (HR 1.77, 95% CI 1.07-2.91) in HCV patients. In addition, among patients with all-cause mortality, arrhythmia death was significantly higher with chronic HCV infection.


CONCLUSIONS
In patients with chronic viral hepatitis, patients with HCV were associated with significantly increased risks of sick sinus syndrome, and all-cause mortality compared to patients with HBV.
['Wu|Victor Chien-Chia|VC|', 'Chen|Tien-Hsing|TH|', 'Wu|Michael|M|', 'Huang|Chien-Hao|CH|', 'Chen|Shao-Wei|SW|', 'Cheng|Chun-Wen|CW|', 'Lin|Yu-Sheng|YS|', 'Chang|Po-Cheng|PC|', 'Hsieh|Ming-Jer|MJ|', 'Wang|Chao-Yung|CY|', 'Chang|Shang-Hung|SH|', 'Wang|Chun-Li|CL|', 'Chu|Pao-Hsien|PH|', 'Wu|Cheng-Shyong|CS|']
D000293:Adolescent D000328:Adult D001145:Arrhythmias, Cardiac D016208:Databases, Factual D005260:Female D016174:Hepacivirus D006515:Hepatitis B virus D019694:Hepatitis B, Chronic D019698:Hepatitis C, Chronic D006801:Humans D015994:Incidence D008297:Male D008875:Middle Aged D057216:Propensity Score D016016:Proportional Hazards Models D012307:Risk Factors D055815:Young Adult
Cardiac arrhythmia Outcome Viral hepatitis