The De-Ritis ratio was an independent predictor of long-term mortality after acute myocardial infarction (adjusted HR 1.23 per 1-SD increase; 95% CI 1.07-1.42; p=0.004).
Cohort (n=1,355)
Does the De-Ritis ratio predict long-term mortality in patients after acute myocardial infarction?
The De-Ritis ratio (AST/ALT) is a strong, independent predictor of long-term mortality after acute myocardial infarction, adding prognostic value beyond standard biomarkers.
Hazard Ratio: 1.23 (95% CI 1.07–1.42)
valor p: p=0.004
Background: Recent evidence suggested levels of aspartate aminotransferase (AST), alanine transaminase (ALT), and AST/ALT ratio (De-Ritis ratio) were associated with a worse outcome after acute myocardial infarction (AMI). However, their value for predicting long-term prognosis remained unknown. Therefore, we investigated the prognostic potential of transaminases on patient outcome after AMI from a long-term perspective. Methods: Data of a large AMI registry including 1355 consecutive patients were analyzed. The Cox regression hazard analysis was used to assess the impact of transaminases and the De-Ritis ratio on long-term mortality. Results: The median De-Ritis ratio for the entire study population was 1.5 (interquartile range IQR: 1.0–2.6). After a median follow-up time of 8.6 years, we found that AST (crude hazard ratio (HR) of 1.19 per 1-SD 95% confidence interval (CI): 1 .09–1.32; p < 0.001) and De-Ritis ratio (crude HR of 1.31 per 1-SD 95% CI: 1.18–1.44; p < 0.001), but not ALT (p = 0.827), were significantly associated with long-term mortality after AMI. After adjustment for confounders independently, the De-Ritis ratio remained a strong and independent predictor for long-term mortality in the multivariate model with an adjusted HR of 1.23 per 1-SD (95% CI: 1.07–1.42; p = 0.004). Moreover, the De-Ritis ratio added prognostic value beyond N-terminal pro-B-Type Natriuretic Peptide, Troponin T, and Creatine Kinase. Conclusion: The De-Ritis ratio is a strong and independent predictor for long-term mortality after AMI. As a readily available biomarker in clinical routine, it might be used to identify patients at risk for fatal cardiovascular events and help to optimize secondary prevention strategies after AMI.
Steininger et al. (Fri,) conducted a cohort in Acute myocardial infarction (AMI) (n=1,355). De-Ritis ratio (AST/ALT ratio) was evaluated on Long-term mortality (HR 1.23, 95% CI 1.07-1.42, p=0.004). The De-Ritis ratio was an independent predictor of long-term mortality after acute myocardial infarction (adjusted HR 1.23 per 1-SD increase; 95% CI 1.07-1.42; p=0.004).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: