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IJCS
Review Article

Cardiac Disorder in Chronic Hepatitis C

André Gustavo da Silva Rezende et al. Edmundo Pessoa Lopes Brivaldo Markman-Filho

Abstract

Chronic hepatitis C (CHC) has a high prevalence in the world. In addition to hepatic complications with cirrhosis in about 20% of patients and high risk for hepatocarcinoma, extrahepatic manifestations may also occur. Cardiac involvement in patients with CHC is associated with several factors, such as increased risk for coronary artery disease, primary cardiomyopathies, or hemodynamic and electrophysiological changes observed in liver cirrhosis. Furthermore, antiviral treatment may, in rare cases, causes cardiovascular adverse effects. Cardiac arrhythmias are the main form of clinical presentation, and, often, markers of poor prognosis in individuals with advanced liver disease. Although some mechanisms that justify these changes have already been reported, many questions remain unanswered, especially about the true involvement of the hepatitis C virus in the genesis of primary cardiac abnormalities, and the risk factors for cardiac-related complications of antiviral treatment.

  • Arrhytmias, Cardiac
  • Cardiomiopathies
  • drug interactions
  • Drug-Related Side Effects and Adverse Reactions
  • Hepatitis C, Chronic
  • Liver Cirrhosis
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Creative Commons Attribution (CC BY) Creative Commons license
07/03/2019 DOI: 10.5935/2359-4802.20190011
Figure 1
IJCS
Original Article

Drug Interactions and Adverse Events in a Cohort of Warfarin Users Attending Public Health Clinics

Christiane de Fátima Colet et al. Tania Alves Amador Isabela Heineck

Abstract

Background:

Warfarin is an oral anticoagulant involved in important interactions with foods and other drugs.

Objectives:

To evaluate the occurrence of adverse events reported by warfarin users and their relationship with drug interactions.

Methods:

This was an open cohort, prospective study conducted in an 18-month period with warfarin users attending public health clinics of the city of Ijuí, Brazil. Data were collected by means of interviews administered at patients’ home every month. Patients’ responses were confirmed by review of medical records when patients sought medical care. Data were analyzed by descriptive statistics. Potential drug interactions were evaluated in a database and vitamin K consumption was quantified using a validated method.

Results:

A total of 68 patients were followed-up; 63 completed the study and 5 died in the study period. Mean number of medications taken by the patients was 9.6 ± 4.5, and mean number of interactions involving warfarin was 2.91 ± 1.52. Most potential interactions increased the risk of bleeding, 61 of them severe interactions and 116 moderate interactions. Eighty-seven episodes of bleeding and 4 episodes of thrombosis were reported by a total of 37 and 4 patients, respectively. At the occurrence of these events, 56.5% of warfarin users were also taking omeprazole, 35.9% were taking simvastatin and 25.0% paracetamol. Most patients had a low vitamin K intake.

Conclusions:

A high frequency of potential interactions between warfarin and other drugs was detected, but a low intake of foods that could possibly affect the effects of warfarin was observed. Based on our results, it seems prudent to follow patients on warfarin therapy for drug-drug interactions, aiming to control adverse effects and to promote a safe and effective therapy.

  • Acetaminophen
  • Anticoagulants / adverse effects
  • Delivery Health Care/statistics & numeral data
  • Drug Incompatibility
  • drug interactions
  • Omeprazole
  • Pharmacovigilance
  • simvastatin
  • Vitamin K
  • Warfarin
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Creative Commons Attribution (CC BY) Creative Commons license
17/12/2018 DOI: 10.5935/2359-4802.20180091 Views 2
ABC
Artigo de Pesquisa

Pharmacokinetics of statins

Francisco Antonio Helfenstein Fonseca

Statins are lipid lowering agents that promote their effects on plasma lipids through the inhibition of HMG-CoA reductase, a crucial enzyme in the cascade of cholesterol synthesis, leading to reduction of tissue cholesterol pool and consequently, to an upregulation of the LDL receptor expression. There are considerable differences among statins regarding some pharmacokinetic properties, such as the coefficient of hydrophilicity, via liver metabolism (especially regarding P450 cytochrome and isoenzymes), plasma half-life and efficacy of serum lipid changes. They may also differ regarding interactions with other drugs that share the same pathway of metabolism. Recently, many pleiotropic effects have been reported with these drugs, such as anti-inflammatory properties, improvement in endothelial function and benefits on hemostasis.

  • drug interactions
  • pharmacokinetics
  • Statins
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Creative Commons Attribution (CC BY) Creative Commons license
02/01/2006 DOI: 10.1590/S0066-782X2005002400003

How to cite this article

EndNote RIS

Electronic Document Format (Vancouver)

Rezende AGS, Lopes EP, Markman-Filho B. Cardiac Disorder in Chronic Hepatitis C. International Journal of Cardiovascular Sciences 2019;32(3):283-9.

Electronic Document Format (ABNT)

Rezende, André Gustavo da Silva; Lopes, Edmundo Pessoa; Markman-Filho, Brivaldo. Cardiac Disorder in Chronic Hepatitis C. International Journal of Cardiovascular Sciences, v. 32, n. 3, p. 283-289, Mar. 2019.

Electronic Document Format (APA)

Rezende, A. G. S., Lopes, E. P., & Markman-Filho, B. (2019). Cardiac Disorder in Chronic Hepatitis C. International Journal of Cardiovascular Sciences, 32(3), 283-289.

Electronic Document Format (ISO)

Rezende, André Gustavo da Silva and Lopes, Edmundo Pessoa and Markman-Filho, Brivaldo. Cardiac Disorder in Chronic Hepatitis C. International Journal of Cardiovascular Sciences [online]. 2019, vol. 32, n. 3, [cited 2026-10-14], pp. 283-289. Available from: <https://journals.cardiol.br/en/article/cardiac-disorder-in-chronic-hepatitis-c/>. ISSN 2359-4802

EndNote RIS

Electronic Document Format (Vancouver)

Colet CF, Amador TA, Heineck I. Drug Interactions and Adverse Events in a Cohort of Warfarin Users Attending Public Health Clinics. International Journal of Cardiovascular Sciences 2018;32(2):110-7.

Electronic Document Format (ABNT)

Colet, Christiane de Fátima; Amador, Tania Alves; Heineck, Isabela. Drug Interactions and Adverse Events in a Cohort of Warfarin Users Attending Public Health Clinics. International Journal of Cardiovascular Sciences, v. 32, n. 2, p. 110-117, Dec. 2018.

Electronic Document Format (APA)

Colet, C. F., Amador, T. A., & Heineck, I. (2018). Drug Interactions and Adverse Events in a Cohort of Warfarin Users Attending Public Health Clinics. International Journal of Cardiovascular Sciences, 32(2), 110-117.

Electronic Document Format (ISO)

Colet, Christiane de Fátima and Amador, Tania Alves and Heineck, Isabela. Drug Interactions and Adverse Events in a Cohort of Warfarin Users Attending Public Health Clinics. International Journal of Cardiovascular Sciences [online]. 2018, vol. 32, n. 2, [cited 2026-10-14], pp. 110-117. Available from: <https://journals.cardiol.br/en/article/drug-interactions-and-adverse-events-in-a-cohort-of-warfarin-users-attending-public-health-clinics/>. ISSN 2359-4802

EndNote RIS

Electronic Document Format (Vancouver)

Fonseca FAH. Pharmacokinetics of statins. Arquivos Brasileiros de Cardiologia 2006;85(suppl 5):9-14.

Electronic Document Format (ABNT)

Fonseca, Francisco Antonio Helfenstein. Pharmacokinetics of statins. Arquivos Brasileiros de Cardiologia, v. 85, n. suppl 5, p. 9-14, Jan. 2006.

Electronic Document Format (APA)

Fonseca, F. A. H. (2006). Pharmacokinetics of statins. Arquivos Brasileiros de Cardiologia, 85(suppl 5), 9-14.

Electronic Document Format (ISO)

Fonseca, Francisco Antonio Helfenstein. Pharmacokinetics of statins. Arquivos Brasileiros de Cardiologia [online]. 2006, vol. 85, n. suppl 5, [cited 2026-10-14], pp. 9-14. Available from: <https://journals.cardiol.br/en/article/pharmacokinetics-of-statins/>. ISSN 0066-782X

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