Abstract
Introduction: Recently, hypoxic liver injury (HLI) has been proposed as a novel prognostic marker for ST-elevation myocardial infarction (STEMI) in small study. So, we evaluated the prognostic implication of HLI at admission in patients with STEMI who underwent primary percutaneous coronary intervention (PCI) in large cohort. Methods: From 2007 to 2014, a total of 1540 consecutive patients (1221 males, mean age 61±13 years old) with STEMI underwent primary PCI were analyzed retrospectively. HLI was defined as ≥ 2-fold increase of serum alanine aminotransferase (ALT) above upper normal limit at the time of presentation. Primary endpoint was in-hospital death. Results: Of all patients, the HLI was noted in 7.7% patients. Compared to patients without HLI, the patients with HLI were younger (58±14 vs. 61±13 years, p=0.043), had lower ejection fraction (43±15 vs. 48±17%, p=0.002). A total of 89 in-hospital death (5.8%) were occurred. Compared to patients without in-hospital death, those patients were older (69±11 vs. 60±13 years old, p<0.001), had higher ALT (65±69 vs. 36±40 IU/L, p<0.001) at the time of presentation and had lower left ventricular ejection fraction (49±12 vs. 27±19, p<0.001). The HLI at the presentation was associated with high in-hospital death (p <0.001) and was an independent predictor of in-hospital death (HR 5.69, CI 3.12-10.38, p<0.001) after adjusted by age, diabetes, sex and shock. Conclusions: The HLI is an independent predictor of in-hospital death in patients with STEMI underwent primary PCI.
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