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- Title
Prognostic significance of transaminases after acute ST-elevation myocardial infarction: insights from a cardiac magnetic resonance study.
- Authors
Reinstadler, Sebastian J.; Reindl, Martin; Feistritzer, Hans-Josef; Klug, Gert; Mayr, Agnes; Kofler, Markus; Tu, Alexander Minh-Duc; Huybrechts, Luc; Mair, Johannes; Franz, Wolfgang-Michael; Metzler, Bernhard
- Abstract
Background: In 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 methods: CMR 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. Results: Admission 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. Conclusions: Transaminases 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.
- Subjects
ALANINE aminotransferase; MYOCARDIAL infarction diagnosis; MYOCARDIAL infarction; CARDIAC magnetic resonance imaging; KAPLAN-Meier estimator; BLOOD sampling; PATIENTS
- Publication
Wiener Klinische Wochenschrift, 2015, Vol 127, Issue 21/22, p843
- ISSN
0043-5325
- Publication type
Article
- DOI
10.1007/s00508-015-0868-6