Prognostic significance of transaminases after acute ST-elevation myocardial infarction: insights from a cardiac magnetic resonance study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-10-06

AUTHORS

Sebastian J. Reinstadler, Martin Reindl, Hans-Josef Feistritzer, Gert Klug, Agnes Mayr, Markus Kofler, Alexander Minh-Duc Tu, Luc Huybrechts, Johannes Mair, Wolfgang-Michael Franz, Bernhard Metzler

ABSTRACT

BackgroundIn patients with ST-elevation myocardial infarction (STEMI), the relationship between transaminases and myocardial damage detected by cardiac magnetic resonance (CMR) imaging is unknown and the prognostic value incompletely investigated.Materials and methodsCMR imaging was performed in 167 STEMI patients 2.3 [1.6–3.9] days after primary percutaneous coronary intervention (PPCI). Blood samples for transaminase measurement (aspartate transaminase (AST) and alanine transaminase (ALT)) were obtained serially from day 1 to day 4 after PPCI. Patients were followed for major adverse cardiac events (MACE) for 2.7 [1.1–3.3] years.ResultsAdmission and peak concentrations of AST and ALT were significantly associated with ejection fraction (p < 0.001), infarct size (p < 0.001), and the presence of microvascular obstruction (p < 0.01). Peak values of both transaminases showed a stronger correlation with CMR parameters than admission values (all p < 0.05). In Kaplan–Meier analysis, a high peak AST or high peak ALT was associated with reduced MACE-free survival (both p < 0.01), whereas admission values were not (both p > 0.05). Peak AST (hazard ratio (HR): 4.93 [1.70–14.32], p = 0.003) and peak ALT (HR: 5.67 [1.94–16.56], p = 0.002) were independent predictors of MACE after adjusting for clinical risk factors.ConclusionsTransaminases measured in the acute phase after PPCI for STEMI are associated with systolic dysfunction, more extensive myocardial necrosis and microvascular injury with subsequent prognostic information on MACE at long-term follow-up. More... »

PAGES

843-850

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00508-015-0868-6

DOI

http://dx.doi.org/10.1007/s00508-015-0868-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1030382459

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26443690


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25 schema:description BackgroundIn patients with ST-elevation myocardial infarction (STEMI), the relationship between transaminases and myocardial damage detected by cardiac magnetic resonance (CMR) imaging is unknown and the prognostic value incompletely investigated.Materials and methodsCMR imaging was performed in 167 STEMI patients 2.3 [1.6–3.9] days after primary percutaneous coronary intervention (PPCI). Blood samples for transaminase measurement (aspartate transaminase (AST) and alanine transaminase (ALT)) were obtained serially from day 1 to day 4 after PPCI. Patients were followed for major adverse cardiac events (MACE) for 2.7 [1.1–3.3] years.ResultsAdmission and peak concentrations of AST and ALT were significantly associated with ejection fraction (p < 0.001), infarct size (p < 0.001), and the presence of microvascular obstruction (p < 0.01). Peak values of both transaminases showed a stronger correlation with CMR parameters than admission values (all p < 0.05). In Kaplan–Meier analysis, a high peak AST or high peak ALT was associated with reduced MACE-free survival (both p < 0.01), whereas admission values were not (both p > 0.05). Peak AST (hazard ratio (HR): 4.93 [1.70–14.32], p = 0.003) and peak ALT (HR: 5.67 [1.94–16.56], p = 0.002) were independent predictors of MACE after adjusting for clinical risk factors.ConclusionsTransaminases measured in the acute phase after PPCI for STEMI are associated with systolic dysfunction, more extensive myocardial necrosis and microvascular injury with subsequent prognostic information on MACE at long-term follow-up.
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51 correlation
52 damage
53 day 1
54 day 4
55 days
56 dysfunction
57 ejection fraction
58 events
59 extensive myocardial necrosis
60 factors
61 fraction
62 higher peak ALT
63 imaging
64 independent predictors
65 infarct size
66 infarction
67 information
68 injury
69 insights
70 intervention
71 magnetic resonance imaging
72 magnetic resonance studies
73 major adverse cardiac events
74 materials
75 measurements
76 microvascular injury
77 microvascular obstruction
78 myocardial damage
79 myocardial infarction
80 myocardial necrosis
81 necrosis
82 obstruction
83 parameters
84 patients
85 peak ALT
86 peak AST
87 peak concentration
88 peak value
89 percutaneous coronary intervention
90 phase
91 predictors
92 presence
93 primary percutaneous coronary intervention
94 prognostic information
95 prognostic significance
96 prognostic value
97 relationship
98 resonance imaging
99 resonance studies
100 risk factors
101 samples
102 significance
103 size
104 strong correlation
105 study
106 survival
107 systolic dysfunction
108 transaminase
109 values
110 years
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