Initial Serum Transaminase Ievels Predict Outcomes In Patients With Acute ST-segment Elevation Myocardial Infarction Who Undergo Primary Percutaneous Coronary Intervention

Objective:Elevated serum transaminases are frequently found in patients with acute ST-elevation myocardial infarction(STEMI).This study assesses the incidence of elevated transaminases in patients with acute ST-segment elevation myocardial infarction and the value of prognosis.Methods:634 patients with STEMI who underwent percutaneous transluminal coronary angioplasty at the First Affiliated Hospital of Suzhou University from January 2013 to August 2015 were selected to collect detailed clinical data of all patients,including sex,age,past medical history,Application of drug history,angiography results,laboratory tests,cardiac ultrasound results;by telephone to follow-up to August 31,2016,which lost 12 people,38 people died.According to the follow-up results were divided into two groups:death group and survival group.SPSS19.0.0 statistical software for statistical analysis,measurement data using mean ± standard deviation(X ± SD)or the median(quartile spacing)that M(IQR)said;group comparison using t test or ranksum Rank sum test.The Cox proportional hazards model is used to quantify the relationship between patient death and various potential risk factors.Survival analysis curves were used to describe the comparison of patients with HLI(hypoxic liver injury)and HH(hypoxic hepatitis),respectively,with unexplained survival.Correlation analysis using Pearson correlation analysis,P <0.05 for the difference was statistically significant.Results:1 ? Of the 622 STEMI patients(aged 62(18)years,with 532 males),38patients(6.1%)died during the follow-up(duration:1063(495)days).These patients were older and had higher AST 625(695)U/L vs.247(236)U/L,ALT 123(133)U/L vs.52(42)U/L,creatine kinase-myocardial band isoenzyme 248.5(407.5)ng/ml vs.184.7(197.0)ng/ml and troponin I 80.0(30.4)ng/ml vs.49.6(61.6)ng/ml from the initial tests at the hospital,all P <0.05.2 ? In the Cox proportional hazards model,ALT(hazard ratio [HR] 1.629,95%confidence interval [CI] 1.093-2.426,P = 0.016)and AST(HR 1.418,95% CI 1.052-1.760,P = 0.003)were STEMI an independent predictor of all-cause mortality after emergency PCI.3?Survival analysis showed that patients with STEMI who had undergone emergency PCI had a lower survival rate than HH in patients who did not develop HH,especially in the short term survival rate,and occurred between HLI and patients who did not develop HLI The rate is not certain.4?There was no significant difference in the increase of transaminase induced by single vessel disease and multivessel disease.However,it was found that LAD blood vessel induced elevated transaminase relative to RCA and LCX iblood vessel in the infarct-related arteries.5?The result of Pearson correlation analysis:AST and ALT were negatively correlated with left ventricular ejection fraction(LVEF),the difference was statistically significant(P<0.05).Conclusion:1 ? Elevated transaminases were common in patients with STEMI after successful emergency PCI,and AST and ALT were negatively correlated with left ventricular ejection fraction.2?AST and ALT are independent predictors of the prognosis of STEMI patients after emergency PCI.3 ? The presence of HH predicts mortality in patients with STEMI who undergo successful primary PCIs.