Prognostic significance of liver enzyme elevations in acute coronary syndromes


Authors: K. Vyskočilová 1;  L. Špinarová 1;  J. Špinar 2;  J. Vítovec 1;  S. Littnerová 3;  T. Mikušová 1;  J. Pařenica 2;  J. Jarkovský 3
Authors‘ workplace: I. interní kardioangiologická klinika LF MU a FN u sv. Anny v Brně a Mezinárodní centrum klinického výzkumu, Brno 1;  Interní kardiologická klinika LF MU a FN Brno 2;  Institut bio­statistiky a analýz LF a PřF MU, Brno 3
Published in: Kardiol Rev Int Med 2014, 16(1): 25-30
Category: Cardiology Review

Overview

Introduction:
The prognostic significance of the laboratory parameters associated with hepatic impairment has been proven in many studies. However, only a few of them focused on the predictive value of liver enzymes in acute coronary syndromes (ACS). The aim of our study was to evaluate the prognostic significance of abnormal liver function tests in patients hospitalised with ACS and concomitant acute heart failure.

Methods and results:
Of 8,818 patients included in the AHEAD (Acute Heart Failure Database) registry, 359 patients had ACS on admission and complete records on aspartate aminotransferase (AST), alanine aminotransferase (ALT), g‑ glutamyltransferase (GGT), and alkaline phosphatase (ALP) serum levels. The incidence of abnormalities was as follows –  AST in 71.3%, ALT in 55.2%, ALP in 11.7% and GGT in 31.8%. A significant association with short‑term (30- day) mortality was found in AST and ALT. A significant influence of AST, ALP and GGT was found in the case of long‑term mortality.

Conclusion:
Despite the development of modern myocardial ischaemia bio­markers, the role of liver function tests due to their high accessibility and affordability remains irreplaceable. As indicated by our study, the predictive value of liver enzymes is also highly important.

Keywords:
liver function tests –  acute heart failure –  myocardial infarction –  prognosis


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Labels
Paediatric cardiology Internal medicine Cardiac surgery Cardiology
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