Author + information
- Jon Suh1,
- Sang-Ho Park2,
- Ho-Jun Jang3,
- Tae-Hoon Kim3,
- Sung Woo Kwon4,
- Sang-Don Park4,
- Woong Chol Kang5,
- Jeonggeun Moon5 and
- Seung-Woon Rha6
- 1SoonChunHyang University Bucheon Hospital, Bucheon, Korea, Republic of
- 2SoonChunHyang University Cheonan Hospital, Cheonan, Korea, Republic of
- 3Sejong General Hospital, Bucheon, Korea, Republic of
- 4Inha University Hospital, Incheon, Korea, Republic of
- 5Gacheon University Gil Medical Center, Incheon, Korea, Republic of
- 6Korea University Guro Hospital, Seoul, Korea, Republic of
Elevated serum aspartate and alanine aminotransferase (AST & ALT) are often observed in patients with ST-segment elevation myocardial infarction (STEMI).
From 2007 to 2014, a total of 1540 consecutive patients (mean age 61±13 years old) with STEMI underwent primary PCI were analyzed retrospectively. Hypoxic liver injury (HLI) was defined as ≥ 2-fold increase of serum ALT above upper normal limit at the time of presentation. Primary endpoint was in-hospital death.
Of all patients, the HLI was noted in 7.7% patients. Compared to patients without HLI, the patients with HLI were younger (58±14 vs. 61±13 years, p=0.043), lower blood pressure (115±34 vs. 125±30 mm Hg, p=0.006), and had lower ejection fraction (43±15 vs. 48±17%, p=0.002). A total of 89 in-hospital death (5.8%) were occurred. Compared to patients without in-hospital death, those patients were older (69±11 vs. 60±13 years old, p<0.001), had higher ALT (65±69 vs. 36±40 IU/L, p<0.001) at the time of presentation and had lower left ventricular ejection fraction (49±12 vs. 27±19, p<0.001). The proximal LAD or LM lesion was not associated with hypoxic liver injury (p=0.835), but proximal RCA lesion was associated with hypoxic liver injury (p=0.002). The proximal RCA lesion was not associated with in-hospital death (p=0.910), but the HLI at the presentation was associated with high in-hospital death (p <0.001) and was an independent predictor of in-hospital death (HR 5.69, CI 3.12-10.38, p<0.001) after adjusted by age, diabetes, sex and shock.
The HLI is an independent predictor of in-hospital death in patients with STEMI underwent primary PCI.