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A High De Ritis Ratio Predicts Poor Myocardial Reperfusion in Patients With ST-Segment Elevation Myocardial

Büşra Güvendi Şengör1, Cemalettin Yılmaz2, Regayip Zehir1

  • 1Department of Cardiology, Kartal Kosuyolu Research and Education Hospital, Istanbul, Turkey.

Angiology
|June 28, 2023
PubMed

Insights

A high De Ritis ratio (AST/ALT) is linked to poor myocardial reperfusion in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI). This easily measured ratio may identify high-risk individuals.

Area of Science:

  • Cardiology
  • Biochemistry
  • Medical Diagnostics

Background:

  • Successful myocardial reperfusion is critical post-primary percutaneous coronary intervention (pPCI) for ST-segment elevation myocardial infarction (STEMI).
  • The De Ritis ratio (AST/ALT) is a biochemical marker with potential prognostic value.

Purpose of the Study:

  • To investigate the association between the De Ritis ratio and myocardial reperfusion in STEMI patients treated with pPCI.
  • To determine if the De Ritis ratio can predict impaired reperfusion after pPCI.

Main Methods:

  • Retrospective analysis of 1236 STEMI patients undergoing pPCI.
  • Patients categorized into low and high De Ritis ratio groups based on the median (.921).
  • Myocardial reperfusion assessed by ST-segment resolution (STR); <70% STR defined as poor reperfusion.

Main Results:

  • A high De Ritis ratio was significantly associated with poor myocardial reperfusion (OR 10.9, P < .001).
  • Stent size (OR 1.45, P = .01) and neutrophil-to-lymphocyte ratio (OR 1.22, P = .03) also correlated with poor reperfusion.
  • The De Ritis ratio demonstrated a strong predictive value for impaired myocardial perfusion.

Conclusions:

  • Elevated De Ritis ratio is a significant predictor of poor myocardial reperfusion in STEMI patients post-pPCI.
  • The De Ritis ratio, being readily available, can aid in identifying STEMI patients at higher risk for inadequate reperfusion.
  • This marker offers a simple tool for risk stratification in clinical practice.

Keywords:
De Ritis ratioST-segment elevation myocardial infarctionacute myocardial infarctionmyocardial reperfusion

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