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1. Factors affecting long‐term changes of liver stiffness in direct‐acting anti‐hepatitis C virus therapy: A multicentre prospective study

Author

Chiara Giorgione, Carmine Coppola, Riccardo Nevola, Vincenzo Messina, Ferdinando Carlo Sasso, Laura Staiano, Rosa Lombardi, Luigi Elio Adinolfi, Annalisa Mazzocca, Antonio Ascione, Luca Rinaldi, Pasquale Perillo, Ernesto Claar, Raffaele Galiero, M.C. Fascione, Valerio Rosato, Anna Ludovica Fracanzani, Giovanna Valente, Aldo Marrone, Guido Piai, Luca Fontanella, Rosato, Valerio, Ascione, Antonio, Nevola, Riccardo, Fracanzani, Anna Ludovica, Piai, Guido, Messina, Vincenzo, Claar, Ernesto, Coppola, Carmine, Fontanella, Luca, Lombardi, Rosa, Staiano, Laura, Valente, Giovanna, Fascione, Maria Chiara, Giorgione, Chiara, Mazzocca, Annalisa, Galiero, Raffaele, Perillo, Pasquale, Marrone, Aldo, Sasso, Ferdinando Carlo, Adinolfi, Luigi Elio, and Rinaldi, Luca

Subjects
Liver Cirrhosis, medicine.medical_specialty, Carcinoma, Hepatocellular, Cirrhosis, Multivariate analysis, Antiviral Agents, Gastroenterology, Virology, Internal medicine, Humans, Medicine, Prospective Studies, Prospective cohort study, Antiviral Treatment, Hepatology, business.industry, Liver Neoplasms, Fatty liver, Hepatocellular Carcinoma, Hepatitis C, medicine.disease, Liver Stiffness, Infectious Diseases, Liver, Hepatocellular carcinoma, Elasticity Imaging Techniques, Steatosis, business, Transient elastography
Abstract

The long-term changes of liver stiffness (LS) in patients who achieve viral clearance after direct-acting anti-HCV therapy remain undefined. We conducted a multicenter prospective study to investigate this aspect. Patients with HCV infection treated with DAAs were enrolled from six Italian centers; they underwent clinical, biochemical, ultrasound, and transient elastography evaluations before treatment (T0), 12 weeks (SVR12), and 24 months (T24) after the end of therapy. Among the 516 consecutive patients enrolled, 301 had cirrhosis. LS significantly decreased from T0 to SVR (14.3 kPa vs 11.1 kPa, p=0.002), with a progressive reduction until T24 (8.7 kPa, p

Published
2021
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2. Impact of hepatitis C virus clearance by direct-acting antiviral treatment on the incidence of major cardiovascular events: A prospective multicentre study

Author

Vito Di Marco, Vincenza Calvaruso, Salvatore Petta, Mariarosaria Saturnino, Riccardo Nevola, Pia Clara Pafundi, Ferdinando Carlo Sasso, Carmine Coppola, Graziano Troina, Aldo Marrone, Francesca Rini, Laura Staiano, Anna Ludovica Fracanzani, Barbara Guerrera, Mauro Giordano, Luigi Elio Adinolfi, Vincenzo Narciso, Rosa Lombardi, Luca Rinaldi, Antonio Craxì, Antonio Solano, Adinolfi L.E., Petta S., Fracanzani A.L., Coppola C., Narciso V., Nevola R., Rinaldi L., Calvaruso V., Staiano L., Di Marco V., Marrone A., Pafundi P.C., Solano A., Lombardi R., Sasso F.C., Saturnino M., Rini F., Guerrera B., Troina G., Giordano M., Craxi A., Adinolfi, Luigi Elio, Petta, Salvatore, Ludovica Fracanzani, Anna, Coppola, Carmine, Narciso, Vincenzo, Nevola, Riccardo, Rinaldi, Luca, Calvaruso, Vincenza, Staiano, Laura, Di Marco, Vito, Marrone, Aldo, Clara Pafundi, Pia, Solano, Antonio, Lombardi, Rosa, Sasso, Ferdinando Carlo, Saturnino, Mariarosaria, Rini, Francesca, Guerrera, Barbara, Troina, Graziano, Giordano, Mauro, and Craxì, Antonio

Subjects
Liver Cirrhosis, Male, 0301 basic medicine, Cirrhosis, Myocardial Ischemia, Comorbidity, Hepacivirus, Disease, 030204 cardiovascular system & hematology, Chronic hepatitis C, medicine.disease_cause, chemistry.chemical_compound, 0302 clinical medicine, Risk Factors, Prospective Studies, Ischemic heart disease, Ischemic cerebral stroke, Chronic hepatitis C, Cirrhosis, Incidence, Incidence (epidemiology), Smoking, Middle Aged, Viral Load, Stroke, Italy, Hypertension, Female, Cardiology and Cardiovascular Medicine, Direct acting, medicine.medical_specialty, Ischemic heart disease, Hepatitis C virus, Hypercholesterolemia, Antiviral Agents, 03 medical and health sciences, Diabetes mellitus, Internal medicine, Diabetes Mellitus, medicine, Humans, Viremia, Aged, Cirrhosi, business.industry, Cholesterol, Hepatitis C, Chronic, medicine.disease, 030104 developmental biology, chemistry, Relative risk, Ischemic cerebral stroke, Hydroxymethylglutaryl-CoA Reductase Inhibitors, business
Abstract

Background and aims: HCV is associated with an increased risk of cardiovascular events (CV). Whether HCV clearance by direct-acting antivirals (DAA) reduces incident CV disease is poorly understood. We investigate whether HCV eradication reduces CV events. Methods: In a prospective multicentre study, 2204 HCV patients (F0–F2:29.5%, F3–F4: 70.5%) were enrolled. Males were 48%, median age was 68 (59–74) years and BMI 25.9 (23.1–28); 24.7% were smokers, 18% had diabetes, 13.2% had cholesterol levels >200 mg/dl and 9.1% took statins, 44% had hypertension. During an overall median follow-up of 28 (24–39) months, incident CV events, such as ischemic heart disease (IHD) and ischemic cerebral stroke (ICS), were recorded. An overall of 2204 patients were evaluated as control group and 1668 patients after HCV elimination were followed as a case group. Factors associated with CV events were evaluated by uni- and multi-variate analyses. Results: Incident CV rates per 100 patient years in pre-treatment and untreated controls and treated cases were 1.12, 1.14 and 0.44 (p = 0.0001 vs. controls), respectively, and a decreased of relative risk (RR = 0.379; p = 0.0002) was observed. CV risk was 2.0–3.5 times lower then in controls (HR 3.671; 95%C.I.:1.871–7.201; p < 0.001). The calculated number of patients to be treated to get a benefit in a patient was 55.26. The annual incidence reduction of CV events was 0.68%. HCV clearance was independently associated with CV events reduction (OR, 4.716; 95% C.I.:1.832–12.138; p = 0.001). Conclusions: HCV clearance by DAA reduces CV events (IHD and ICS) with both clinical and socio-economic benefits.

Published
2020
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3. Clinical features and comorbidity pattern of HCV infected migrants compared to native patients in care in Italy: A real-life evaluation of the PITER cohort

Author

Maria Giovanna Quaranta, Luigina Ferrigno, Xhimi Tata, Franca D'Angelo, Marco Massari, Carmine Coppola, Elisa Biliotti, Alessia Giorgini, Diletta Laccabue, Alessia Ciancio, Pier Luigi Blanc, Marzia Margotti, Donatella Ieluzzi, Maurizia Rossana Brunetto, Francesco Barbaro, Francesco Paolo Russo, Ilaria Beretta, Giulia Morsica, Gabriella Verucchi, Annalisa Saracino, Massimo Galli, Loeta A. Kondili, Cesare Mazzaro, Manuela Bertola, Ornella Schioppa, Antonio Benedetti, Laura Schiadà, Monica Cucco, Andrea Giacometti, Laura Brescini, Sefora Castelletti, Alessandro Fiorentini, Gioacchino Angarano, Michele Milella, Alfredo Di Leo, Maria Rendina, Fulvio Salvatore D'abramo, Chiara Lillo, Andrea Iannone, Mariano Piazzolla, Lorenzo Badia, Fabio Piscaglia, Francesca Benevento, Ilaria Serio, Francesco Castelli, Serena Zaltron, Angiola Spinetti, Silvia Odolini, Raffaele Bruno, Mario Mondelli, Luchino Chessa, Martina Loi, Carlo Torti, Chiara Costa, Maria Mazzitelli, Vincenzo Pisani, Vincenzo Scaglione, Enrico Maria Trecarichi, Anna Linda Zignego, Monica Monti, Francesco Madia, Letizia Attala, Piera Pierotti, Elena Salomoni, Elisa Mariabelli, Teresa Antonia Santantonio, Serena Rita Bruno, Ester Marina Cela, Matteo Bassetti, Giovanni Mazzarello, Anna Ida Alessandrini, Antonio Di Biagio, Laura Ambra Nicolini, Giovanni Raimondo, Roberto Filomia, Alessio Aghemo, Rossella Meli, Adriano Lazzarin, Stefania Salpietro, Anna Ludovica Fracanzani, Erika Fatta, Rosa Lombardi, Pietro Lampertico, Marta Borghi, Roberta D'ambrosio, Elisabetta Degasperi, Massimo Puoti, Chiara Baiguera, Federico D'amico, Maria Vinci, Maria Grazia Rumi, Massimo Zuin, Paola Zermiani, Pietro Andreone, Paolo Caraceni, Valeria Guarneri, Erica Villa, Veronica Bernabucci, Laura Bristot, Maria Luisa Paradiso, Guglielmo Migliorino, Alessandra Gambaro, Giuseppe Lapadula, Anna Spolti, Alessandro Soria, Pietro Invernizzi, Antonio Ciaccio, Martina LucÀ, Federica Malinverno, Laura Ratti, Daniela Caterina Amoruso, Federica Pisano, Ferdinando Scarano, Laura Staiano, Filomena Morisco, Valentina Cossiga, Ivan Gentile, Antonio Riccardo Buonomo, Maria Foggia, Emanuela Zappulo, Alessandro Federico, Marcello Dallio, Nicola Coppola, Caterina Sagnelli, Salvatore Martini, Caterina Monari, Gerardo Nardone, Costantino Sgamato, Liliana Chemello, Luisa Cavalletto, Daniela Sterrantino, Alberto Zanetto, Paola Zanaga, Giuseppina Brancaccio, Antonio Craxì, Salvatore Petta, Vincenza Calvaruso, Luciano Crapanzano, Salvatore Madonia, Marco Cannizzaro, Erica Maria Bruno, Anna Licata, Simona Amodeo, Adele Rosaria Capitano, Carlo Ferrari, Elisa Negri, Alessandra Orlandini, Marco Pesci, Roberto Gulminetti, Layla Pagnucco, Giustino Parruti, Paola Di Stefano, Barbara Coco, Romina Corsini, Elisa Garlassi, Massimo Andreoni, Elisabetta Teti, Carlotta Cerva, Lorenzo Baiocchi, Giuseppe Grassi, Antonio Gasbarrini, Maurizio Pompili, Martina De Siena, Gloria Taliani, Martina Spaziante, Marcello Persico, Mario Masarone, Andrea Aglitti, Gemma Calvanese, Marco Anselmo, Pasqualina De Leo, Monica Marturano, Giorgio Maria Saracco, Quaranta M.G., Ferrigno L., Tata X., D'Angelo F., Massari M., Coppola C., Biliotti E., Giorgini A., Laccabue D., Ciancio A., Blanc P.L., Margotti M., Ieluzzi D., Brunetto M.R., Barbaro F., Russo F.P., Beretta I., Morsica G., Verucchi G., Saracino A., Galli M., Kondili L.A., Mazzaro C., Bertola M., Benedetti A., Schiada L., Cucco M., Giacometti A., Brescini L., Castelletti S., Fiorentini A., Angarano G., Milella M., Leo A.D., Rendina M., Salvatore D'ABRAMO F., Lillo C., Iannone A., Piazzolla M., Badia L., Piscaglia F., Benevento F., Serio I., Castelli F., Zaltron S., Spinetti A., Odolini S., Bruno R., Mondelli M., Chessa L., Loi M., Torti C., Costa C., Mazzitelli M., Pisani V., Scaglione V., Trecarichi E.M., Zignego A.L., Monti M., Madia F., Attala L., Pierotti P., Salomoni E., Mariabelli E., Santantonio T.A., Bruno S.R., Cela E.M., Bassetti M., Mazzarello G., Alessandrini A.I., Biagio A.D., Nicolini L.A., Raimondo G., Filomia R., Aghemo A., Meli R., Lazzarin A., Salpietro S., Fracanzani A.L., Fatta E., Lombardi R., Lampertico P., Borghi M., D'ambrosio R., Degasperi E., Puoti M., Baiguera C., D'AMICO F., Vinci M., Rumi M.G., Zuin M., Zermiani P., Andreone P., Caraceni P., Guarneri V., Villa E., Bernabucci V., Bristot L., Paradiso M.L., Migliorino G., Gambaro A., Lapadula G., Spolti A., Soria A., Invernizzi P., Ciaccio A., LucA M., Malinverno F., Ratti L., Amoruso D.C., Pisano F., Scarano F., Staiano L., Morisco F., Cossiga V., Gentile I., Buonomo A.R., Foggia M., Zappulo E., Federico A., Dallio M., Coppola N., Sagnelli C., Martini S., Monari C., Nardone G., Sgamato C., Chemello L., Cavalletto L., Sterrantino D., Zanetto A., Zanaga P., Brancaccio G., Craxi A., Petta S., Calvaruso V., Crapanzano L., Madonia S., Cannizzaro M., Bruno E.M., Licata A., Amodeo S., Capitano A.R., Ferrari C., Negri E., Orlandini A., Pesci M., Gulminetti R., Pagnucco L., Parruti G., Stefano P.D., Coco B., Corsini R., Garlassi E., Andreoni M., Teti E., Cerva C., Baiocchi L., Grassi G., Gasbarrini A., Pompili M., Siena M.D., Taliani G., Spaziante M., Persico M., Masarone M., Aglitti A., Calvanese G., Anselmo M., Leo P.D., Marturano M., Saracco G.M., Quaranta, M, Ferrigno, L, Tata, X, D'Angelo, F, Massari, M, Coppola, C, Biliotti, E, Giorgini, A, Laccabue, D, Ciancio, A, Blanc, P, Margotti, M, Ieluzzi, D, Brunetto, M, Barbaro, F, Russo, F, Beretta, I, Morsica, G, Verucchi, G, Saracino, A, Galli, M, Kondili, L, Mazzaro, C, Bertola, M, Benedetti, A, Schiada, L, Cucco, M, Giacometti, A, Brescini, L, Castelletti, S, Fiorentini, A, Angarano, G, Milella, M, Leo, A, Rendina, M, Salvatore D'ABRAMO, F, Lillo, C, Iannone, A, Piazzolla, M, Badia, L, Piscaglia, F, Benevento, F, Serio, I, Castelli, F, Zaltron, S, Spinetti, A, Odolini, S, Bruno, R, Mondelli, M, Chessa, L, Loi, M, Torti, C, Costa, C, Mazzitelli, M, Pisani, V, Scaglione, V, Trecarichi, E, Zignego, A, Monti, M, Madia, F, Attala, L, Pierotti, P, Salomoni, E, Mariabelli, E, Santantonio, T, Bruno, S, Cela, E, Bassetti, M, Mazzarello, G, Alessandrini, A, Biagio, A, Nicolini, L, Raimondo, G, Filomia, R, Aghemo, A, Meli, R, Lazzarin, A, Salpietro, S, Fracanzani, A, Fatta, E, Lombardi, R, Lampertico, P, Borghi, M, D'Ambrosio, R, Degasperi, E, Puoti, M, Baiguera, C, D'Amico, F, Vinci, M, Rumi, M, Zuin, M, Zermiani, P, Andreone, P, Caraceni, P, Guarneri, V, Villa, E, Bernabucci, V, Bristot, L, Paradiso, M, Migliorino, G, Gambaro, A, Lapadula, G, Spolti, A, Soria, A, Invernizzi, P, Ciaccio, A, Luca, M, Malinverno, F, Ratti, L, Amoruso, D, Pisano, F, Scarano, F, Staiano, L, Morisco, F, Cossiga, V, Gentile, I, Buonomo, A, Foggia, M, Zappulo, E, Federico, A, Dallio, M, Coppola, N, Sagnelli, C, Martini, S, Monari, C, Nardone, G, Sgamato, C, Chemello, L, Cavalletto, L, Sterrantino, D, Zanetto, A, Zanaga, P, Brancaccio, G, Craxi, A, Petta, S, Calvaruso, V, Crapanzano, L, Madonia, S, Cannizzaro, M, Bruno, E, Licata, A, Amodeo, S, Capitano, A, Ferrari, C, Negri, E, Orlandini, A, Pesci, M, Gulminetti, R, Pagnucco, L, Parruti, G, Stefano, P, Coco, B, Corsini, R, Garlassi, E, Andreoni, M, Teti, E, Cerva, C, Baiocchi, L, Grassi, G, Gasbarrini, A, Pompili, M, Siena, M, Taliani, G, Spaziante, M, Persico, M, Masarone, M, Aglitti, A, Calvanese, G, Anselmo, M, Leo, P, Marturano, M, Saracco, G, Quaranta, M. G., Ferrigno, L., Tata, X., D'Angelo, F., Massari, M., Coppola, C., Biliotti, E., Giorgini, A., Laccabue, D., Ciancio, A., Blanc, P. L., Margotti, M., Ieluzzi, D., Brunetto, M. R., Barbaro, F., Russo, F. P., Beretta, I., Morsica, G., Verucchi, G., Saracino, A., Galli, M., Kondili, L. A., Mazzaro, C., Bertola, M., Benedetti, A., Schiada, L., Cucco, M., Giacometti, A., Brescini, L., Castelletti, S., Fiorentini, A., Angarano, G., Milella, M., Leo, A. D., Rendina, M., Salvatore D'ABRAMO, F., Lillo, C., Iannone, A., Piazzolla, M., Badia, L., Piscaglia, F., Benevento, F., Serio, I., Castelli, F., Zaltron, S., Spinetti, A., Odolini, S., Bruno, R., Mondelli, M., Chessa, L., Loi, M., Torti, C., Costa, C., Mazzitelli, M., Pisani, V., Scaglione, V., Trecarichi, E. M., Zignego, A. L., Monti, M., Madia, F., Attala, L., Pierotti, P., Salomoni, E., Mariabelli, E., Santantonio, T. A., Bruno, S. R., Cela, E. M., Bassetti, M., Mazzarello, G., Alessandrini, A. I., Biagio, A. D., Nicolini, L. A., Raimondo, G., Filomia, R., Aghemo, A., Meli, R., Lazzarin, A., Salpietro, S., Fracanzani, A. L., Fatta, E., Lombardi, R., Lampertico, P., Borghi, M., D'Ambrosio, R., Degasperi, E., Puoti, M., Baiguera, C., D'Amico, F., Vinci, M., Rumi, M. G., Zuin, M., Zermiani, P., Andreone, P., Caraceni, P., Guarneri, V., Villa, E., Bernabucci, V., Bristot, L., Paradiso, M. L., Migliorino, G., Gambaro, A., Lapadula, G., Spolti, A., Soria, A., Invernizzi, P., Ciaccio, A., Luca, M., Malinverno, F., Ratti, L., Amoruso, D. C., Pisano, F., Scarano, F., Staiano, L., Morisco, F., Cossiga, V., Gentile, I., Buonomo, A. R., Foggia, M., Zappulo, E., Federico, A., Dallio, M., Coppola, N., Sagnelli, C., Martini, S., Monari, C., Nardone, G., Sgamato, C., Chemello, L., Cavalletto, L., Sterrantino, D., Zanetto, A., Zanaga, P., Brancaccio, G., Craxi, A., Petta, S., Calvaruso, V., Crapanzano, L., Madonia, S., Cannizzaro, M., Bruno, E. M., Licata, A., Amodeo, S., Capitano, A. R., Ferrari, C., Negri, E., Orlandini, A., Pesci, M., Gulminetti, R., Pagnucco, L., Parruti, G., Stefano, P. D., Coco, B., Corsini, R., Garlassi, E., Andreoni, M., Teti, E., Cerva, C., Baiocchi, L., Grassi, G., Gasbarrini, A., Pompili, M., Siena, M. D., Taliani, G., Spaziante, M., Persico, M., Masarone, M., Aglitti, A., Calvanese, G., Anselmo, M., Leo, P. D., Marturano, M., and Saracco, G. M.

Subjects
Male, HCV genotypes, Ethnic group, Linked-to-care patient, Comorbidity, Hepacivirus, Logistic regression, medicine.disease_cause, Comorbidities, Direct acting antivirals, HCV Cohort, Linked-to-care patients, Aged, Antiviral Agents, Coinfection, Female, Hepatitis C, Chronic, Humans, Italy, Middle Aged, Transients and Migrants, 0302 clinical medicine, Medicine, Chronic, Gastroenterology, virus diseases, Hepatitis C, Life evaluation, 030220 oncology & carcinogenesis, Cohort, 030211 gastroenterology & hepatology, Comorbiditie, Human, Hepatitis C virus, Settore MED/12 - GASTROENTEROLOGIA, 03 medical and health sciences, Disease severity, Antiviral Agent, Hepaciviru, Hepatology, business.industry, Settore MED/09 - MEDICINA INTERNA, medicine.disease, digestive system diseases, Direct acting antiviral, business, Demography
Abstract

Background: Direct-acting antivirals are highly effective for the treatment of hepatitis C virus (HCV) infection, regardless race/ethnicity. We aimed to evaluate demographic, virological and clinical data of HCV-infected migrants vs. natives consecutively enrolled in the PITER cohort. Methods: Migrants were defined by country of birth and nationality that was different from Italy. Mann-Whitney U test, Chi-squared test and multiple logistic regression were used. Results: Of 10,669 enrolled patients, 301 (2.8%) were migrants: median age 47 vs. 62 years, (p < 0.001), females 56.5% vs. 45.3%, (p < 0.001), HBsAg positivity 3.8% vs. 1.4%, (p < 0.05). Genotype 1b was prevalent in both groups, whereas genotype 4 was more prevalent in migrants (p < 0.05). Liver disease severity and sustained virologic response (SVR) were similar. A higher prevalence of comorbidities was reported for natives compared to migrants (p < 0.05). Liver disease progression cofactors (HBsAg, HIV coinfection, alcohol abuse, potential metabolic syndrome) were present in 39.1% and 47.1% (p > 0.05) of migrants and natives who eradicated HCV, respectively. Conclusion: Compared to natives, HCV-infected migrants in care have different demographics, HCV genotypes, viral coinfections and comorbidities and similar disease severity, SVR and cofactors for disease progression after HCV eradication. A periodic clinical assessment after HCV eradication in Italians and migrants with cofactors for disease progression is warranted.

Published
2021

4. Changing epidemiology of patients treated with direct acting antivirals for HCV and persistently high SVR12 in an endemic area for HCV infection in Italy: real-life ‘LIver Network Activity’ (LINA) cohort update results

Author

Salvatore Martini, Simona Mercinelli, Nicola Coppola, Biagio Pinchera, Vincenzo Messina, Carmine Coppola, G. Stornaiuolo, Maria Stanzione, Mariagiovanna Nerilli, Riccardo Scotto, Antonio Riccardo Buonomo, Ivan Gentile, Laura Staiano, Stefania De Pascalis, Letizia Cattaneo, Scotto, R., Buonomo, A. R., De Pascalis, S., Nerilli, M., Pinchera, B., Staiano, L., Mercinelli, S., Cattaneo, L., Stanzione, M., Stornaiuolo, G., Martini, S., Messina, V., Coppola, C., Coppola, N., Gentile, I., Scotto, Riccardo, Buonomo, Antonio Riccardo, De Pascalis, Stefania, Nerilli, Mariagiovanna, Pinchera, Biagio, Staiano, Laura, Mercinelli, Simona, Cattaneo, Letizia, Stanzione, Maria, Stornaiuolo, Gianfranca, Martini, Salvatore, Messina, Vincenzo, Coppola, Carmine, Coppola, Nicola, and Gentile, Ivan

Subjects
Research design, Cyclopropanes, Liver Cirrhosis, Male, Cirrhosis, Aminoisobutyric Acids, Pyrrolidines, Sustained Virologic Response, Hepacivirus, DIRECT ACTING ANTIVIRALS, Liver disease, 0302 clinical medicine, Epidemiology, Prospective Studies, Prospective cohort study, Sulfonamides, Gastroenterology, Imidazoles, Endemic area, Middle Aged, Italy, 030220 oncology & carcinogenesis, Cohort, HCV, 030211 gastroenterology & hepatology, Female, epidemiology, Adult, medicine.medical_specialty, Genotype, Proline, Lactams, Macrocyclic, Antiviral Agents, Heterocyclic Compounds, 4 or More Rings, 03 medical and health sciences, Age Distribution, Leucine, Internal medicine, Quinoxalines, medicine, Humans, real-life, Aged, Benzofurans, Retrospective Studies, DAA, Hepatology, business.industry, Hepatitis C, Chronic, medicine.disease, Amides, SVR12, Benzimidazoles, Carbamates, business
Abstract

Background: Second generation direct acting antivirals (DAAs) drastically changed the landscape of chronic HCV (CHCV). Aim of this paper was to assess the effectiveness of DAAs, also looking at the demographic characteristics of subjects enrolled. Research design and methods: Ambispective multi-center real-life study conducted among patients with CHCV treated with DAAs in Campania Region (Southern Italy). Patient were enrolled in two cohorts according to time of enrolment. Results: 1,479 patients were enrolled. Patients aged ≥60 years were 74.7% in the historic cohort (953 patients) and 70.2% in the prospective cohort (526 patients. Patients aged ≥ 60 years showed a higher prevalence of genotype 1b (p

Published
2021

5. Screening, Linkage to Care and Treatment of Hepatitis C Infection in Primary Care Setting in the South of Italy

Author

Carmine Coppola, Francesca Futura Bernardi, Maria D'Antò, Anna Citarella, Simona Cammarota, Angelo Salomone Megna, Marcello Persico, Mario Masarone, Valeria Conti, U. Trama, Carmine Sellitto, Massimo Smaldone, Elio Giusto, Laura Staiano, Rosa Servodio, and Marianna Fogliasecca

Subjects
medicine.medical_specialty, Hepatitis C virus, barriers, Primary care, Newly diagnosed, medicine.disease_cause, General Biochemistry, Genetics and Molecular Biology, Article, 03 medical and health sciences, primary care, 0302 clinical medicine, eradication, medicine, direct acting antivirals, 030212 general & internal medicine, lcsh:Science, Ecology, Evolution, Behavior and Systematics, Specialist care, Linkage (software), business.industry, Public health, proactive case-finding, Paleontology, virus diseases, Retrospective cohort study, Hepatitis C, medicine.disease, digestive system diseases, Space and Planetary Science, Family medicine, 030211 gastroenterology & hepatology, lcsh:Q, business
Abstract

Hepatitis C virus (HCV) infection remains a pressing public health issue. Our aim is to assess the linkage to care of patients with HCV diagnosis and to support the proactive case-finding of new HCV-infected patients in an Italian primary care setting. This was a retrospective cohort study of 44 general practitioners (GPs) who managed 63,955 inhabitants in the Campania region. Adults with already known HCV diagnosis or those with HCV high-risk profile at June 2019 were identified and reviewed by GPs to identify newly diagnosed of HCV and to assess the linkage to care and treatment for the HCV patients. Overall, 698 HCV patients were identified, 596 with already known HCV diagnosis and 102 identified by testing the high-risk group (2614 subjects). The 38.8% were already treated with direct-acting antivirals, 18.9% were referred to the specialist center and 42.3% were not sent to specialist care for treatment. Similar proportions were found for patients with an already known HCV diagnosis and those newly diagnosed. Given that the HCV infection is often silent, case-finding needs to be proactive and based on risk information. Our findings suggested that there needs to be greater outreach, awareness and education among GPs in order to enhance HCV testing, linkage to care and treatment.

Published
2020

6. Author response for 'Reduced incidence of type 2 diabetes in patients with chronic hepatitis C virus infection cleared by direct‐acting antivirals therapy. A prospective study'

Author

Ferdinando Carlo Sasso, Salvatore Petta, Antonio Solano, Vito Di Marco, Luigi Elio Adinolfi, Luca Rinaldi, Aldo Marrone, Riccardo Nevola, Graziano Troina, Mauro Giordano, Anna Ludovica Fracanzani, Antonio Craxì, Mariarosaria Saturnino, Pia Clara Pafundi, Francesca Rini, Laura Staiano, Carmine Coppola, Barbara Guerrera, Vincenza Calvaruso, Rosa Lombardi, and Vincenzo Narciso

Subjects
medicine.medical_specialty, business.industry, Incidence (epidemiology), Type 2 diabetes, DIRECT ACTING ANTIVIRALS, medicine.disease, Virus, Chronic hepatitis, Internal medicine, Medicine, In patient, business, Prospective cohort study, Clearance
Published
2020
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7. Associated screening for HCV and SARS-Cov2 infection in an urban area of Southern Italy: the 'Casola di Napoli' cohort study

Author

Carmine Coppola, Laura Staiano, Ivan Gardini, M. Conforti, Mario Masarone, D. Amoruso, Pietro Torre, Maria Persico, and M. Bartoli

Subjects
2019-20 coronavirus outbreak, geography, geography.geographical_feature_category, Hepatology, Coronavirus disease 2019 (COVID-19), business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Gastroenterology, Urban area, OC-4, Environmental health, Medicine, business, Cohort study
Published
2021
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8. Reduced incidence of type 2 diabetes in patients with chronic hepatitis C virus infection cleared by direct-acting antiviral therapy: A prospective study

Author

Antonio Solano, Anna Ludovica Fracanzani, Ferdinando Carlo Sasso, Salvatore Petta, Pia Clara Pafundi, Antonio Craxì, Riccardo Nevola, Barbara Guerrera, Carmine Coppola, Vito Di Marco, Rosa Lombardi, Vincenzo Narciso, Aldo Marrone, Vincenza Calvaruso, Luigi Elio Adinolfi, Luca Rinaldi, Mariarosaria Saturnino, Mauro Giordano, Francesca Rini, Laura Staiano, Graziano Troina, Adinolfi L.E., Petta S., Fracanzani A.L., Nevola R., Coppola C., Narciso V., Rinaldi L., Calvaruso V., Pafundi P.C., Lombardi R., Staiano L., Di Marco V., Solano A., Marrone A., Saturnino M., Rini F., Guerrera B., Troina G., Giordano M., Craxi A., Sasso F.C., Adinolfi, Luigi E, Petta, Salvatore, Fracanzani, Anna L, Nevola, Riccardo, Coppola, Carmine, Narciso, Vincenzo, Rinaldi, Luca, Calvaruso, Vincenza, Pafundi, Pia Clara, Lombardi, Rosa, Staiano, Laura, Di Marco, Vito, Solano, Antonio, Marrone, Aldo, Saturnino, Mariarosaria, Rini, Francesca, Guerrera, Barbara, Troina, Graziano, Giordano, Mauro, Craxì, Antonio, and Sasso, Ferdinando C

Subjects
medicine.medical_specialty, Cirrhosis, endocrine system diseases, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Type 2 diabetes, 030204 cardiovascular system & hematology, Antiviral Agents, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, chronic hepatiti, Internal medicine, Internal Medicine, medicine, Humans, Glucose homeostasis, Prospective Studies, Prospective cohort study, direct-acting antiviral, business.industry, Incidence, Incidence (epidemiology), nutritional and metabolic diseases, Type 2 Diabetes Mellitus, Hepatitis C, Chronic, medicine.disease, Diabetes Mellitus, Type 2, Case-Control Studies, Relative risk, HCV, Population study, type 2 diabetes, business, cirrhosi
Abstract

Aim HCV infection increases the risk of type 2 diabetes mellitus (T2DM). However, it remains still unclear whether HCV clearance by direct-acting antivirals (DAA) reduces T2DM. Therefore, the effect of HCV eradication on T2DM incidence was assessed. Methods A prospective multicenter case-control study was performed, which included 2,426 HCV patients, 42% of which with liver fibrosis F0-F2 and 58% F3-F4. Study population consisted of a control group including 1099 untreated patients and 1327 cases treated with DAA. T2DM incidence was assessed during a follow-up median period of 30 [IQR: 28-42] months. Risk factors of T2DM were assessed by Cox regression model (Relative risk (RR), Hazard risk (HR), Kaplan-Meier). Insulin sensitivity was evaluated by HOMA and changes by ANOVA for repeated measurements. Factors independently associated with T2DM were assessed by multivariate analysis RESULTS: The absolute incidence of T2DM/1,000 person-years for controls and cases was 28 and 7, respectively (p=0.001). In cases compared to controls, HCV clearance reduced the RR and HR of T2DM by 81% and 75-93% respectively (p = 0.001). It has been calculated that for every 15 patients who obtained HCV clearance one case of T2DM is saved. HCV clearance was associated with a significant reduction in HOMA-IR and HOMA- β and an increase in HOMA-S as assessed in 384 patients before and after HCV clearance. At multivariate analysis, HCV clearance emerged as independently associated with a reduced T2DM risk. Conclusion HCV clearance by DAA treatment reduces T2DM incidence more likely by restoring the HCV-induced alteration of glucose homeostasis mechanisms. This article is protected by copyright. All rights reserved.

Published
2020

9. Direct acting antivirals treatment for hepatitis C virus infection does not increase the incidence of de novo hepatocellular carcinoma occurrence: Results from an Italian real-life cohort (LINA cohort)

Author

Riccardo Scotto, Grazia Tosone, Salvatore Nappa, Mariarosaria Saturnino, Costanza Maria Rapillo, Giulio Viceconte, Ivan Gentile, Stefania De Pascalis, Carmine Coppola, Salvatore Martini, Federica Portunato, Antonio Riccardo Buonomo, Ferdinando Scarano, Laura Staiano, Mariantonietta Pisaturo, Nicola Coppola, Biagio Pinchera, Buonomo, A. R., Scotto, R., Coppola, C., Pinchera, B., Viceconte, G., Rapillo, C. M., Staiano, L., Saturnino, M., Scarano, F., Portunato, F., Pisaturo, M., De Pascalis, S., Martini, S., Tosone, G., Nappa, S., Coppola, N., and Gentile, I.

Subjects
Male, medicine.medical_specialty, real-world, Carcinoma, Hepatocellular, Hepatitis C virus, medicine.disease_cause, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, direct acting antiviral, Internal medicine, medicine, 030212 general & internal medicine, Prospective cohort study, Survival analysis, Aged, Antiviral Agent, business.industry, Incidence (epidemiology), Incidence, General Medicine, Hepatitis C, hepatocellular carcinoma, Hepatitis C, Chronic, Middle Aged, medicine.disease, Survival Analysis, digestive system diseases, Prospective Studie, Italy, Liver Neoplasm, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Cohort, HCV, Female, Cohort Studie, business, Cohort study, Human
Abstract

The effectiveness of direct-acting antivirals (DAAs) against hepatitis C virus (HCV) infection is ascertained. However, some authors raised the issue of an increased incidence of de novo hepatocellular carcinoma (HCC) in patients treated with DAAs. Aim of the study was to evaluate the rate of HCC occurrence in a real-life cohort of patients who received anti-HCV treatment with DAAs.A prospective multicentre study was conducted. All adult patients with HCV infection who received treatment between March 2015 and December 2017 in 4 hospital of Campania region (South Italy) with at least 6 months of follow-up were enrolled.A total of 323 patients were included in the study. Most patients had HCV genotype 1b (61.8%). The overall SVR12 rate was 95.5%. Median time of observation was 10 months. The incidence rate of HCC was 0.2 per 100 person-months (crude incidence rate 3.4%, 95 confidence interval: 1.5%-5.3%). The median time for HCC occurrence was 11 months. HCC occurrence rate was significantly higher among patients who did not achieve SVR12 compared with patients who did (28.6% vs 2.8%, P

Published
2020

10. Interferon-free regimens improve kidney function in patients with chronic hepatitis C infection

Author

Salvatore Martini, Daniela Caterina Amoruso, Stefania De Pascalis, Antonio Riccardo Buonomo, Federica Portunato, Ivan Gentile, Mariantonietta Pisaturo, Nicola Coppola, Biagio Pinchera, Laura Staiano, Carmine Coppola, Riccardo Scotto, Coppola, N., Portunato, F., Buonomo, A. R., Staiano, L., Scotto, R., Pinchera, B., De Pascalis, S., Amoruso, D. C., Martini, S., Pisaturo, M., Coppola, C., Gentile, I., Coppola, Nicola, Portunato, Federica, Buonomo, Antonio Riccardo, Staiano, Laura, Scotto, Riccardo, Pinchera, Biagio, De Pascalis, Stefania, Amoruso, Daniela Caterina, Martini, Salvatore, Pisaturo, Mariantonietta, Coppola, Carmine, and Gentile, Ivan

Subjects
Male, Nephrology, medicine.medical_specialty, Cirrhosis, Hepatitis C virus, 030232 urology & nephrology, Renal function, 030204 cardiovascular system & hematology, medicine.disease_cause, Antiviral Agents, Gastroenterology, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Diabetes mellitus, medicine, CKD, eGFR, Humans, Aged, DAA, Antiviral Agent, business.industry, Recovery of Function, Hepatitis C, Hepatitis C, Chronic, Middle Aged, Symptom Flare Up, medicine.disease, HCV infection, Regimen, Treatment Outcome, Interferon, Female, Interferons, Cohort Studie, business, Viral load, Human, Glomerular Filtration Rate
Abstract

Background and aim: The impact of directly acting antiviral agent (DAA) regimens on renal function is not well defined and quite controversial. We evaluated the effect of DAAs on kidney function and the factors associated with an improvement or worsening. Patients and methods: The changes in estimated glomerular filtration rate (eGFR) in a cohort of 403 patients treated with a DAA regimen were evaluated. Results: The overall sustained virological response (SVR12) rate was 98%. The median eGFR progressively increased throughout treatment from 84.54ml/min/1.73m2 (IQR 70.8–97.3) to 88.12ml/min/1.73m2. Conversely, rates of patients with a eGFR more than 60ml/min/1.73m2 progressively increased from 83.1% at baseline to 87.8% at 12weeks post-treatment (p < 0.05). Considering the change in eGFR according to the different factors, a significant improvement in eGFR was observed in the patients without diabetes (p < 0.001), in those with cirrhosis (p < 0.05), in those receiving a Sof-based regimen (p < 0.01) or not receiving RBV (p < 0.05), in those with a baseline eGFR less than 60ml/min/1.73m2 (p < 0.001) and in those with SVR (p < 0.05). An improvement in eGFR (defined as an increase in baseline eGFR of at least 10ml/min/1.73m2) was observed in 148 patients (36.7%). At multivariate analysis, age (aHR 0.96; 95 CI 0.93–0.99, p < 0.01) and a diagnosis of diabetes (aHR 0.02; 95 CI 0.20–0.87, p < 0.05) were inversely and independently associated with improvement in renal function, while the presence of Child–Pugh B cirrhosis at baseline was associated with an improvement in renal function (aHR 3.07; 95 CI 1.49–6.30, p < 0.01). Conclusions: DAAs correlate with an improvement in renal function, underlining the importance of hepatitis C virus eradication to achieve also an improvement in extra-hepatic disorders.

Published
2019

11. Treatment with direct-acting antivirals improves the clinical outcome in patients with HCV-related decompensated cirrhosis: results from an Italian real-life cohort (Liver Network Activity-LINA cohort)

Author

Laura Staiano, Nicola Coppola, Grazia Tosone, Stefania De Pascalis, Carmine Coppola, Daniela Caterina Amoruso, Riccardo Scotto, Guglielmo Borgia, Margherita Macera, Federica Portunato, Giulio Viceconte, Antonio Riccardo Buonomo, Teresa De Simone, Salvatore Martini, Ivan Gentile, Gentile, I., Scotto, R., Coppola, C., Staiano, L., Amoruso, D. C., De Simone, T., Portunato, F., De Pascalis, S., Martini, S., Macera, M., Viceconte, G., Tosone, G., Buonomo, A. R., Borgia, G., and Coppola, N.

Subjects
Liver Cirrhosis, Male, medicine.medical_specialty, Cirrhosis, Hepatitis C virus, Liver Cirrhosi, medicine.disease_cause, Direct-acting antiviral, Gastroenterology, Antiviral Agents, Decompensated cirrhosi, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Liver Function Tests, Internal medicine, Medicine, Humans, Prospective Studies, Aged, Antiviral Agent, Hepatology, business.industry, Liver Function Test, Hepatitis C, Chronic, medicine.disease, Colorectal surgery, Discontinuation, Prospective Studie, Treatment Outcome, Liver, 030220 oncology & carcinogenesis, Cohort, 030211 gastroenterology & hepatology, Female, Liver function, business, Hepatitis C viru, Human
Abstract

Background: Direct-acting antivirals (DAAs) are safe and effective for the treatment of HCV infection. However, data regarding their efficacy in patients with Child–Pugh B cirrhosis are scarce and their capability in improving liver function is debated. The aim of our study was to assess the clinical benefits of treatment with DAA in subjects with Child–Pugh B cirrhosis. Methods: We conducted a prospective multicentre study among patients with Child–Pugh B cirrhosis of an Italian real-life HCV cohort (LINA cohort) who received treatment with DAAs. Results: Among 89 patients enrolled, the rate of sustained virologic response 12 was 95.5%. No discontinuation occurred, no patient died during treatment. Most patients had Genotype 1 (1b 61.8%, 1a 11.2%). Conversely, 22.5%, 1.1% and 3.4% of patients had Genotype 2, 3 and 4, respectively. At last observation, 61.8% of patients switched to a Class A cirrhosis, 33.7% remained in Class B and 4.5 worsened to Child C (p < 0.001). Liver parameters significantly improved from baseline to 12weeks after the end of treatment. Previous anti-HCV treatments and the presence of decompensated cirrhosis at 1month of treatment were significantly associated with a decompensated cirrhosis at the last observation. Conclusions: Treatment with DAA in patients with Child–Pugh B cirrhosis is safe and leads to a very high rate of viral clearance, a significant rate of re-compensation and an improvement in liver function. Further studies are needed to assess the impact of treatment on survival and quality of life in long-term follow-up.

Published
2018

12. Steatosis in patients with HCV chronic liver disease: Baseline results from patients enrolled in the PITER cohort study

Author

L. Falzano, D. Ieluzzi, L. Nicolini, M.C. Pasetto, V. Rizzo, A. Orlandini, Cappelletti Mattia, B. Stagno, M. Borghi, M. Dallio, F.P. Russo, A. Rocco, M. Massella, L. Cavalletto, V. Donati, M. Milella, Alessia Ciancio, O. Patti, A. Mallano, D. Drenaggi, S. Petta, M.G. Faraci, P. Colombato, F. D’Aversa, Maria Giovanna Quaranta, A. Giammario, T. Tieghi, M. Margotti, S. Camera, Giulia Morsica, S. Zaltron, Mario Masarone, F. Giancotti, A. Iannone, L.E. Weimer, L. Giubilei, P. Blanc, L. Valenti, Loreta A. Kondili, L. Framarin, E.M. Erne, S. Rosato, C. Cerva, Ivan Gentile, M. Gonzo, F. Tamburrini, E. Danieli, M. Vinci, S. Storato, S. Pellicano, R. Filomia, A.R. Capitano, R. Corsini, Laura Staiano, Weimer, L. E., Falzano, L., Mallano, A., Quaranta, M. G., Massella, M., Rosato, S., Colombato, P., Giubilei, L., Ciancio, A., Iannone, A., Filomia, R., Orlandini, A., Petta, S., Tamburrini, F., Blanc, P., D’Aversa, F., Pasetto, M. C., Erne, E. M., Ieluzzi, D., Storato, S., Margotti, M., Vinci, M., Russo, F. P., Patti, O., Rizzo, V., Giammario, A., Gentile, Ivan, Donati, V., Staiano, L., Masarone, M., Cavalletto, L., Gonzo, M., Giancotti, F., Danieli, E., Corsini, R., Faraci, M. G., Valenti, L., Cappelletti, M., Camera, S., Pellicano, S., Stagno, B., Tieghi, T., Milella, M., Dallio, M., Rocco, A., Borghi, M., Drenaggi, D., Zaltron, S., Morsica, G., Framarin, L., Capitano, A. R., Cerva, C., Nicolini, L., and Kondili, L.

Subjects
medicine.medical_specialty, Hepatology, business.industry, Internal medicine, Gastroenterology, medicine, In patient, Steatosis, Chronic liver disease, medicine.disease, Baseline (configuration management), business, Cohort study
Published
2015

13. Italian survey on HBV and liver transplantation in a cohort of 2260 patients

Author

Mariarosa Tamè, F. Caneschi, R. Fasulo, Manuela Merli, Mauro Salizzoni, I. Bortoluzzi, L. Sangiovanni, Ruggiero Francavilla, Paolo Forte, Guido Piai, P. Conoscitore, C. Cusumano, Maria Grazia Lucà, Laura Staiano, G. Parrilli, Riccardo Volpes, P. Andreone, Patrizia Boccagni, Giuseppe Tisone, Carmine Coppola, Nicola Caporaso, Patrizia Burra, M. Mazzola, Angelo V. Marzano, Rosa Maria Iemmolo, S. Bongiovanni, I. Lenisa, D. Cocchis, L. De Carlis, G.B. Gaeta, Giovanni Vennarecci, S. Mirabella, A. Lotti Suffredini, Stefano Fagiuoli, Ranka Vukotic, M. Scarpellini, Iacopo Mangoni, G. Stornaiuolo, M.R. Piras, M. Rendina, V. Giannelli, P. Russo, L. Mameli, Alessandro Anselmo, Lucio Caccamo, Fausto Zamboni, and Pierluigi Toniutto

Subjects
medicine.medical_specialty, Hepatology, business.industry, medicine.medical_treatment, Internal medicine, Cohort, Gastroenterology, Medicine, Liver transplantation, business
Published
2014
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14. PANTOPRAZOLE AND RABEPRAZOLE DO NOT IMPACT THE ACTIVITY OF CYTOCHROME P450 ASSESSED BY [13C]-AMINOPYRINE BREATH TEST IN PATIENTS WITH LIVER CIRRHOSIS

Author

Alba Rocco, Debora Compare, D. Angrisani, C. Rubicondo, Laura Staiano, D. Amoruso, Carmine Coppola, and Gerardo Nardone

Subjects
Breath test, HBsAg, medicine.medical_specialty, Cirrhosis, Hepatology, medicine.diagnostic_test, business.industry, Gastroenterology, Rabeprazole, medicine.disease, Liver disease, Virion assembly, Internal medicine, medicine, Steatosis, business, Viral load, medicine.drug
Abstract

s / Digestive and Liver Disease 47S (2015) e43–e66 e63 driving the synthesis of abnormal peptides, possibly leading to virion assembly defects and to the intracytoplasmatic accumulation of HBsAg. Conclusions Selective pressure by the immune system selects variants in theprecore region that arenotproportionally detectable in the periphery, possibly due to the abnormal release of defective virions. This may also have clinical implications for hepatic pathology (steatosis) andmay lead to the underestimation of viral load. A better comprehensionof the relationshipbetween intrahepatic and peripheral (virological and clinical) markers may confer to these a higher diagnostic power. http://dx.doi.org/10.1016/j.dld.2015.01.136

Published
2015
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15. Cardiac structure and function and arterial circulation in hypertensive patients with and without metabolic syndrome

Author

L. A. Ferrara, Mario Mancini, G. De Luca, Fabio Ferrara, L. Staiano, Aldo Celentano, L. Guida, Ferrara, LIBERATO ALDO, Lucio, Guida, Fabio, Ferrara, GIULIANO DE, Luca, Laura, Staiano, Aldo, Celentano, and Marcello, Mancini

Subjects
Adult, Male, medicine.medical_specialty, Ambulatory blood pressure, End organ damage, Ventricular Function, Left, Muscle hypertrophy, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Outpatient clinic, Humans, Metabolic Syndrome, business.industry, Myocardium, Carotid ultrasonography, Heart, Middle Aged, medicine.disease, Blood pressure, Hypertension, Cardiology, Female, Hypertrophy, Left Ventricular, Metabolic syndrome, business
Abstract

High blood pressure (BP) is one of the crucial determinants of the metabolic syndrome (MS). The extent to which MS, diagnosed according to the criteria of the International Federation of Diabetes, impacts on cardiovascular organ damage, independently of BP, is debated. Three hundred and forty hypertensive patients and 100 normotensive controls underwent the following procedures: (1) physical examination and resting BP measurements, (2) 24 h ambulatory BP monitoring, (3) laboratory routine examination, (4) echocardiography, (5) carotid ultrasonography and (6) ankle-brachial BP index. The syndrome was found in 104 of the 340 hypertensive patients (30.6). In comparison to those without MS, those with MS had significantly higher prevalence of left ventricular (LV) hypertrophy by mass/height(2.7) criteria (46 vs 42%, P0.01) but not by LV mass/body surface criteria (30 vs 31%); the ratio between early-to-late peak velocities of the LV filling waves (E/A) was higher (E/A=0.99+/-0.14 vs 0.89+/-0.15, P0.01) and left atrium was larger (3.8+/-0.3 vs 3.5+/-0.5 cm, P0.01). Both hypertensive groups had significantly greater LVM and carotid intima-media thickness than normotensives, without between-group-difference. In this hypertension outpatient clinic almost one-third hypertensive patients have MS. They show a deterioration in structure and function of the heart in comparison to hypertensive patients without MS, but no difference was detected in the carotid and peripheral arterial circulation.

Published
2007

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