Baseline low ALT activity is associated with increased long-term mortality after COPD exacerbations

Area of Science:

• Pulmonary Medicine
• Biomarkers
• Geriatrics

Background:

• COPD exacerbations significantly impact patient survival.
• Muscle dysfunction and mass loss are linked to poorer prognosis in COPD.
• Low Alanine amino-transferase (ALT) is an indicator of sarcopenia and frailty.

Purpose of the Study:

• To investigate the association between low ALT levels and long-term survival in patients hospitalized with COPD exacerbation.
• To determine if ALT can serve as a prognostic biomarker for mortality in this patient group.

Main Methods:

• Historic prospective cohort study.
• Inclusion of 232 consecutive patients hospitalized for acute COPD exacerbation.
• Exclusion of patients with hepatic tissue damage (ALT > 40 IU).

Main Results:

• 44.8% of patients died during a median follow-up of 34.9 months.
• Patients with ALT < 11 IU had a significantly higher mortality rate (69%) and shorter median survival (18.5 months).
• Low ALT levels (especially < 11 IU) were independently associated with increased long-term mortality risk (adjusted HR = 1.83).

Conclusions:

• Low ALT levels are a significant independent predictor of poor long-term survival in COPD patients hospitalized for exacerbation.
• ALT may serve as a valuable biomarker for identifying frail patients at higher risk of mortality.
• This finding highlights the importance of muscle mass and sarcopenia in COPD prognosis.