Jian Li1, Zhuo Zhao2, Hui Jiang3, Minjie Jiang1, Ge Yu1, Xu Li4. 1. Department of Hepatology, The First Hospital of Jilin University, No. 71, Xinmin Street, Changchun, Jilin, China. 2. Department of Cardiology, The Second Hospital of Jilin University, Changchun, Jilin, China. 3. Medical Oncology Department, Jilin Cancer Hospital, Changchun, Jilin, China. 4. Department of Hepatology, The First Hospital of Jilin University, No. 71, Xinmin Street, Changchun, Jilin, China. jdyylx@jlu.edu.cn.
Abstract
BACKGROUND AND AIMS: Liver enzymes, including alanine aminotransferase (ALT) and aspartate aminotransferase (AST), are markers of hepatic dysfunction and fatty liver disease. Although ALT and AST have been suggested as risk factors for cardiovascular disease, their role as predictors of mortality after acute myocardial infarction (AMI) has not been established. The objective of this study was to investigate the predictive value of ALT and AST for mortality in patients with AMI. METHODS: We analyzed records of 712 patients with AMI and no known liver disease treated at the Department of Cardiovascular Center in the First Hospital of Jilin University. The primary outcome was all-cause in-hospital mortality. Relationships between primary outcome and various risk factors, including serum transaminase levels, were assessed using multivariate logistic regression analysis. RESULTS: Age (P < 0.001), hypertension (P = 0.034), prior myocardial infarction (P < 0.001), AST (P < 0.001), ALT (P < 0.001), creatinine (P = 0.007), blood urea nitrogen (P = 0.006), and troponin I (P < 0.001) differed significantly between ST-segment elevation myocardial infarction (STEMI) and non-STEMI. The following factors were associated with an increased risk of in-hospital all-cause mortality in patients with AMI: ALT ≥ 2ULN (adjusted odds ratio [AOR] 2.240 [95% confidence interval (CI), 1.331-3.771]; P = 0.002); age ≥ 65 year (AOR 4.320 [95% CI 2.687-6.947]; P < 0.001); increased fasting plasma glucose (FPG) (AOR 2.319 [95% CI 1.564-3.438]; P < 0.001); elevated D-dimer (AOR 2.117 [95% CI 1.407-3.184]; P < 0.001); elevated fibrinogen (AOR 1.601 [95% CI 1.077-2.380]; P = 0.20); and reduced estimated glomerular filtration rate (eGFR) (AOR 2.279 [95% CI 1.519-3.419]; P < 0.001). CONCLUSIONS: Our findings demonstrated that elevated ALT was independently associated with increased in-hospital all-cause mortality in patients with AMI. Other risk factors were increased age, FPG, D-dimer, and fibrinogen and decreased eGFR.
BACKGROUND AND AIMS: Liver enzymes, including alanine aminotransferase (ALT) and aspartate aminotransferase (AST), are markers of hepatic dysfunction and fatty liver disease. Although ALT and AST have been suggested as risk factors for cardiovascular disease, their role as predictors of mortality after acute myocardial infarction (AMI) has not been established. The objective of this study was to investigate the predictive value of ALT and AST for mortality in patients with AMI. METHODS: We analyzed records of 712 patients with AMI and no known liver disease treated at the Department of Cardiovascular Center in the First Hospital of Jilin University. The primary outcome was all-cause in-hospital mortality. Relationships between primary outcome and various risk factors, including serum transaminase levels, were assessed using multivariate logistic regression analysis. RESULTS: Age (P < 0.001), hypertension (P = 0.034), prior myocardial infarction (P < 0.001), AST (P < 0.001), ALT (P < 0.001), creatinine (P = 0.007), blood ureanitrogen (P = 0.006), and troponin I (P < 0.001) differed significantly between ST-segment elevation myocardial infarction (STEMI) and non-STEMI. The following factors were associated with an increased risk of in-hospital all-cause mortality in patients with AMI: ALT ≥ 2ULN (adjusted odds ratio [AOR] 2.240 [95% confidence interval (CI), 1.331-3.771]; P = 0.002); age ≥ 65 year (AOR 4.320 [95% CI 2.687-6.947]; P < 0.001); increased fasting plasma glucose (FPG) (AOR 2.319 [95% CI 1.564-3.438]; P < 0.001); elevated D-dimer (AOR 2.117 [95% CI 1.407-3.184]; P < 0.001); elevated fibrinogen (AOR 1.601 [95% CI 1.077-2.380]; P = 0.20); and reduced estimated glomerular filtration rate (eGFR) (AOR 2.279 [95% CI 1.519-3.419]; P < 0.001). CONCLUSIONS: Our findings demonstrated that elevated ALT was independently associated with increased in-hospital all-cause mortality in patients with AMI. Other risk factors were increased age, FPG, D-dimer, and fibrinogen and decreased eGFR.
Authors: Mert İlker Hayıroğlu; Emrah Bozbeyoglu; Özlem Yıldırımtürk; Ahmet İlker Tekkeşin; Seçkin Pehlivanoğlu Journal: Turk Kardiyol Dern Ars Date: 2020-01