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In Acute Myocardial Infarction Liver Parameters Are Associated With Stenosis Diameter

Theodor Baars1, Ursula Neumann, Mona Jinawy

  • 1From the Department for Cardiology, West German Heart and Vascular Centre Essen, University Hospital, University Duisburg-Essen, Essen, Germany (TB, MJ, SH, RE); Department of Bioinformatics, Straubing Center of Science, University of Applied Science Weihenstephan-Triesdorf, Straubing, Germany (UN, MR, DH); and Department of Gastroenterology and Hepatology, University Hospital, University Duisburg-Essen (J-PS, JK, GG, AC), Essen, Germany.

Medicine
|February 13, 2016
PubMed

Insights

Noninvasive liver enzymes and routine blood markers can predict coronary artery stenosis severity in acute myocardial infarction (AMI) patients. This may reduce the need for invasive cardiac catheterization in low-risk individuals.

Area of Science:

  • Cardiology
  • Biochemistry
  • Medical Diagnostics

Background:

  • Acute myocardial infarction (AMI) necessitates accurate risk stratification to guide treatment.
  • Intracardiac catheterization, while definitive, carries risks and complications.
  • Liver enzymes are implicated in cardiovascular disease risk, suggesting a potential role in AMI assessment.

Purpose of the Study:

  • To analyze the predictive value of liver serum markers for coronary artery stenosis severity in AMI patients.
  • To identify noninvasive parameters that can assess stenosis severity, potentially avoiding invasive procedures.

Main Methods:

  • Retrospective evaluation of 437 AMI patients undergoing percutaneous coronary intervention (PCI).
  • Quantitative coronary angiography to determine minimal lumen diameter (MLD) and percent stenosis diameter (SD).
  • Random forests (RF) analysis to associate routine heart and liver parameters with SD, developing a prediction model (M10).

Main Results:

  • Significant differences in age, alkaline phosphatase (AP), aspartate aminotransferase (AST), and MLD were observed between stenosis severity groups (SD ≥ 50% vs. < 50%).
  • Age, AST, alanine aminotransferase (ALT), and troponin correlated significantly with SD; MLD showed an inverse correlation.
  • The M10 model (including age, BMI, AP, AST, ALT, gamma-glutamyltransferase, creatinine, troponin) achieved an AUC of 69.7% for predicting stenosis severity.

Conclusions:

  • Routine liver parameters are significantly associated with coronary artery stenosis severity in AMI.
  • A noninvasive model using readily available parameters can identify stenosis severity in AMI.
  • This approach may help avoid unnecessary coronary angiography in lower-risk AMI patients.

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