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Erschienen in: Wiener klinische Wochenschrift 21-22/2015

01.11.2015 | original article

Prognostic significance of transaminases after acute ST-elevation myocardial infarction: insights from a cardiac magnetic resonance study

verfasst von: MD Sebastian J. Reinstadler, MD Martin Reindl, MD Hans-Josef Feistritzer, MD Gert Klug, MD Agnes Mayr, MD Markus Kofler, MD Alexander Minh-Duc Tu, MD Luc Huybrechts, MD Johannes Mair, MD Wolfgang-Michael Franz, MD, MSc Bernhard Metzler

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 21-22/2015

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Summary

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.
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Metadaten
Titel
Prognostic significance of transaminases after acute ST-elevation myocardial infarction: insights from a cardiac magnetic resonance study
verfasst von
MD Sebastian J. Reinstadler
MD Martin Reindl
MD Hans-Josef Feistritzer
MD Gert Klug
MD Agnes Mayr
MD Markus Kofler
MD Alexander Minh-Duc Tu
MD Luc Huybrechts
MD Johannes Mair
MD Wolfgang-Michael Franz
MD, MSc Bernhard Metzler
Publikationsdatum
01.11.2015
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 21-22/2015
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-015-0868-6