De Ritis ratio and long-term major cardiovascular adverse events in patients undergoing elective percutaneous...

Area of Science:

• Cardiology
• Biomarkers
• Clinical Outcomes

Background:

• The prognostic value of the aspartate aminotransferase to alanine aminotransferase ratio (De Ritis ratio) in chronic coronary syndromes (CCS) is not well-established.
• This study investigates the association between the De Ritis ratio and adverse cardiovascular events in CCS patients.

Purpose of the Study:

• To evaluate the relationship between the De Ritis ratio and long-term adverse cardiovascular events.
• To determine if the De Ritis ratio can predict mortality and other major adverse cardiovascular events in patients with CCS.

Main Methods:

• A cohort of 5020 patients with CCS undergoing percutaneous coronary intervention (PCI) was analyzed.
• Patients were stratified into three groups based on De Ritis ratio tertiles (<.75, .75-1.08, >1.08).
• The primary endpoint was 3-year mortality, with secondary endpoints including myocardial infarction, stroke, and bleeding events.

Main Results:

• Elevated De Ritis ratios were significantly associated with increased 3-year mortality (5.0% vs. 7.5% vs. 14.5%), myocardial infarctions (2.6% vs. 3.5% vs. 5.1%), and strokes (1.0% vs. 1.2% vs. 1.9%).
• Bleeding events at 30 days also showed a significant increase with higher De Ritis ratios (1.4% vs. 1.6% vs. 3.7%).
• Inclusion of the De Ritis ratio improved the predictive accuracy of a Cox proportional hazards model for all-cause mortality (delta C-statistic = .003, p = .005).

Conclusions:

• An elevated De Ritis ratio is a significant predictor of long-term major adverse cardiovascular events in patients with CCS undergoing PCI.
• The De Ritis ratio provides incremental prognostic information beyond traditional risk factors for adverse outcomes in this patient population.