Liver and cholestatic parameters as prognostic biomarkers of in-hospital MACE in patients with STEMI.

Abstract

Liver and cholestatic parameters are increased in ST-segment elevation myocardial infarction (STEMI). The aim of the present study was to evaluate the prognostic value of these parameters to predict in-hospital major adverse cardiac events (MACE) in patients after STEMI. Blood samples of patients with STEMI, who underwent percutaneous coronary intervention (PCI) and stent implantation, were retrospectively analysed and correlated with in-hospital events. The study population consisted of 847 consecutive patients (62·4±13·43years; 73·8% male). The total in-hospital MACE rate was 9·8%, driven by death of any cause (8·4%). The Mann-Whitney U-test revealed that liver and cholestatic parameters (alanine transaminase P<0·0001, aspartate transaminase P<0·0001, alkaline phosphatase (AP) P<0·0001, gamma-glutamyl transferase P=0·0006 and total bilirubin P=0·0023) were significantly higher in the MACE group. Further logistic regression analyses confirmed the correlation between MACE and all five laboratory markers, even after adjustment for age and heart enzymes. Logistic regression model revealed AP to be the best predictor for worth outcome (OR 1·0188; 95% CI 1·0118-1·0258; P<0·0001). Liver and cholestatic parameters are elevated in patients after STEMI. Increased AP is associated with in-hospital event rates.