Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Sunday, 12 / 16 / 2018

Articles

Risk of Cardiovascular Events in Patients with Primary Biliary Cholangitis - Systematic Review

ORIGINAL ARTICLE

Risk of Cardiovascular Events in Patients with Primary Biliary Cholangitis - Systematic Review

Duminda Suraweera1, Christina Fanous2, Melissa Jimenez2, Myron J. Tong3 and Sammy Saab*2,4

1Department of Medicine, Olive-View Medical Center, Sylmar, CA, USA
2Department of Surgery at the University of California at Los Angeles, Los Angeles, CA, USA
3Huntington Research Institute, Pasadena, CA, USA
4Department of Medicine at the University of California at Los Angeles, Los Angeles, CA, USA

*Correspondence to: Sammy Saab, Pfleger Liver Institute, UCLA Medical Center, 200 Medical Plaza, Suite 214, Los Angeles, CA 90095, USA. Tel: +1-310-206-6705, Fax: +1-310-206-4197, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2018;6(2):119-126 DOI: 10.14218/JCTH.2017.00064
Received: October 7, 2017 Accepted: January 2, 2018 Published online: February 14, 2018

Abstract

Background and Aims: Hypercholesterolemia is a common finding in patients with primary biliary cholangitis (PBC) and is a well-defined risk factor for cardiovascular disease. However, studies have been mixed on whether PBC patients do, in fact, have higher cardiovascular risk. The aim of this study is to review the current literature and provide an evidence-based assessment of cardiovascular risk in PBC patients.

Methods: We performed a systematic literature search on PubMed regarding patients with PBC and cardiovascular events from the database inception to July 1, 2017. A total of 33 articles fulfilling our inclusion criteria were found.

Results: The majority of the studies evaluated yielded no statistically significant difference in cardiovascular disease in the PBC population compared to the general public. However, some reports found a statistically significantly increase in coronary artery disease. Several studies have looked at the specific lipid profile of patients with PBC with hypocholesteremia. While these lipid abnormalities differ by stage of disease, there is evidence to suggest that the specific lipid profile in PBC may have lower atherogenicity than in patients with hypercholesterolemia without PBC. Studies looking at patients with PBC with other risk factors for cardiovascular disease, such as hypertension and metabolic syndrome, have consistently found a higher risk for cardiovascular disease in these patients. Statin treatment is effective in reducing lipid levels and possibly improving endothelial inflammation in patients with PBC with hypercholesterolemia.

Conclusions: There is not enough evidence to suggest an increased risk of cardiovascular disease in patients with PBC with hypercholesterolemia, except for those individuals with concomitant features of metabolic syndrome. In patients with PBC with no additional cardiovascular risk factors, individual risk/benefit discussion on lipid-lowering treatment should be considered.

Keywords

Primary biliary cholangitis (PBC), Cardiovascular risk, Hypercholesterolemia

 

 

Journal of Clinical and Translational Hepatology 2018 vol. 6, 119-126  [ Html ] [ PDF Full-text ]

© The Authors 2018. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

 

 

 logo

You are here: Home