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The relationship between insulin resistance, serum alkaline phosphatase, and left ventricular dysfunction following

Qifeng Guo1,2, Mengdan Miao1, Linan Duan1

  • 1Department of Heart Center, the First Hospital of Hebei Medicical University, 89Donggang Road, Shijiazhuang, 050000, Hebei, China.

Scientific Reports
|October 20, 2023
PubMed

Insights

Elevated alkaline phosphatase (AP) and left anterior descending artery involvement are risk factors for reduced left ventricular ejection fraction (LVEF) after acute myocardial infarction (AMI). However, triglycerides may offer a protective effect against severe LVEF decline in AMI patients.

Area of Science:

  • Cardiology
  • Biochemistry

Background:

  • Heart failure post-acute myocardial infarction (AMI) increases mortality risk.
  • Alkaline phosphatase (AP) is an independent predictor of cardiovascular disease (CVD) and adverse outcomes, and is linked to insulin resistance (IR).

Purpose of the Study:

  • To investigate the correlation between IR surrogates (TyG index, TG/HDL-C ratio), AP, and left ventricular (LV) dysfunction in post-AMI patients.
  • To identify predictors of reduced LVEF in patients hospitalized for AMI.

Main Methods:

  • Retrospective study of 774 AMI patients who underwent coronary angiography.
  • Patients were grouped by serum AP levels.
  • Clinical, echocardiographic, coronary angiography, and biochemical data were collected.
  • Left ventricular ejection fraction (LVEF) assessed via echocardiography.

Main Results:

  • The triglyceride-glucose (TyG) index correlated significantly with the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio (R=0.739, P<0.001).
  • Elevated serum AP (OR 2.598, P=0.005) and left anterior descending (LAD) artery as infarct-related artery (IRA) (OR 2.452, P=0.003) were independent risk factors for LVEF < 40% post-AMI.
  • Triglyceride (TG) levels were a protective factor (OR 0.652, P=0.046) against severe LVEF reduction.

Conclusions:

  • Serum AP and LAD as IRA are independent risk factors for severe LVEF reduction during AMI hospitalization.
  • Triglycerides act as an independent protective factor against severe LVEF reduction in AMI patients.

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