Impact of serum alkaline phosphatase level on coronary collateral circulation

Serum alkaline phosphatase (ALP) level has been shown to be a prognostic factor for myocardial infarction and stroke via its promotion of vascular calcification.

To investigate for the first time the correlation between serum ALP level and coronary collateral circulation (CCC) development.

A total of 356 patients with stable angina pectoris were evaluated retrospectively. Patients were classified according to ALP level and CCC grade. Rentrop 0-1 flow was defined as impaired CCC. Serum ALP > 129 mg/dL in men and > 104 mg/dL in women was defined as elevated ALP. All groups were compared statistically according to clinical, laboratory and demographic features.

Impaired CCC was observed in 53.7% of the patients. The mean ALP level was 102.8 ± 57.9 mg/dL, and elevated ALP levels were obtained in 19.4% of cases. There was a significant correlation between ALP and CCC grade, and impaired CCC was associated with relatively higher ALP values (65.2% vs. 50.9%, p = 0.03). Multivariate regression analysis also showed a significant correlation between elevated ALP level and impaired CCC (OR 1.85, with a 95% CI 1.056-3.264; p = 0.03).

Serum ALP is a widely avaliable unfavourable prognostic parameter in coronary heart disease. Elevated ALP levels were associated with inadequate CCC, which supports the previously reported literature concerning the negative prognostic value of ALP levels in cardiovascular settings.