eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
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abstract:
Clinical research

Liver parameters as part of a non-invasive model for prediction of all-cause mortality after myocardial infarction

Theodor Baars, Jan-Peter Sowa, Ursula Neumann, Stefanie Hendricks, Mona Jinawy, Julia Kälsch, Guido Gerken, Tienush Rassaf, Dominik Heider, Ali Canbay

Arch Med Sci
Online publish date: 2018/05/15
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Introduction
Liver parameters are associated with cardiovascular disease risk and severity of stenosis. It is unclear whether liver parameters could predict the long-term outcome of patients after acute myocardial infarction (AMI). We performed an unbiased analysis of the predictive value of serum parameters for long-term prognosis after AMI.

Material and methods
In a retrospective, observational, single-center, cohort study, 569 patients after AMI were enrolled and followed up until 6 years for major adverse cardiovascular events, including cardiac death. Patients were classified into non-survivors (n = 156) and survivors (n = 413). Demographic and laboratory data were analyzed using ensemble feature selection (EFS) and logistic regression. Correlations were performed for serum parameters.

Results
Age (73; 64; p < 0.01), alanine aminotransferase (ALT; 93 U/l; 40 U/l; p < 0.01), aspartate aminotransferase (AST; 162 U/l; 66 U/l; p < 0.01), C-reactive protein (CRP; 4.7 U/l; 1.6 U/l; p < 0.01), creatinine (1.6; 1.3; p < 0.01), -glutamyltransferase (GGT; 71 U/l; 46 U/l; p < 0.01), urea (29.5; 20.5; p < 0.01), estimated glomerular filtration rate (eGFR; 49.6; 61.4; p < 0.01), troponin (13.3; 7.6; p < 0.01), myoglobin (639; 302; p < 0.01), and cardiovascular risk factors (hypercholesterolemia p < 0.02, family history p < 0.01, and smoking p < 0.01) differed significantly between non-survivors and survivors. Age, AST, CRP, eGFR, myoglobin, sodium, urea, creatinine, and troponin correlated significantly with death (r = –0.29; 0.14; 0.31; –0.27; 0.20; –0.13; 0.33; 0.24; 0.12). A prediction model was built including age, CRP, eGFR, myoglobin, and urea, achieving an AUROC of 77.6% to predict long-term survival after AMI.

Conclusions
Non-invasive parameters, including liver and renal markers, can predict long-term outcome of patients after AMI.

keywords:

non-invasive prediction, liver enzymes, percutaneous coronary intervention, troponin

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