Key result
An elevated AST/ALT ratio (≥ 1.40) was independently associated with a significantly increased risk of all-cause mortality (HR 2.93) in patients with stable coronary artery disease.
Why the study?
To explore the association between the AST/ALT ratio and all-cause mortality in stable coronary artery disease patients treated by PCI.
Is an elevated AST/ALT ratio associated with increased all-cause mortality in patients with stable coronary artery disease treated by PCI?
Cohort (n=203)
No
Is an elevated AST/ALT ratio associated with increased all-cause mortality in patients with stable coronary artery disease treated by PCI?
Hazard Ratio: 2.93 (95% CI 1.08–7.91)
Absolute Event Rate: 16.22% vs 4.65%
p-value: p=0.034
An elevated AST/ALT ratio (≥ 1.40) is an independent prognostic factor for all-cause mortality in stable CAD patients treated with PCI, suggesting its utility as a simple biomarker for risk stratification.
Elevated AST/ALT ratio may aid post-PCI risk stratification in stable CAD; leaves open prospective validation and added value.
The aim of this study is to explore the association between the aspartate amino transferase (AST)/alanine aminotransferase (ALT) ratio and all-cause mortality (ACM) in stable coronary artery disease (CAD) patients treated by percutaneous coronary intervention (PCI). The study is a secondary analysis of a retrospective cohort study involving 203 stable CAD patients. Patients were divided into two groups, based on the optimal AST/ALT ratio threshold calculated by the ROC curve (low group: AST/ALT ratio < 1.40; high group: AST/ALT ratio ≥ 1.40). Results were compared using hazard ratio (HR) and a 95% confidence interval (CI). ACM occurred in 18 patients after an average follow-up time of 749 (435-1122) days. Among them, ACM occurred in 6 patients in the low group and 12 patients in the high group, with significant differences between the groups (4.65% versus 16.22%, P value = 0.005). In the Kaplan-Meier analysis, an elevated AST/ALT ratio was associated with increased ACM in stable ACD patients (HR 3.78, 95% CI 1.44-9.93, P value < 0.001). An elevated AST/ALT ratio was still found to be an independent prognostic factor for ACM (HR 2.93, 95% CI 1.08-7.91, P value = 0.034) after adjusting for potential confounders. Therefore, an elevated AST/ALT ratio is an independent prognostic factor for ACM in stable ACD patients.
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Liu et al. (2022) conducted a cohort in Stable coronary artery disease (n=203). Elevated AST/ALT ratio (≥ 1.40) vs. Low AST/ALT ratio (< 1.40) was evaluated on All-cause mortality (ACM) (HR 2.93, 95% CI 1.08-7.91, p=0.034). An elevated AST/ALT ratio (≥ 1.40) was independently associated with a significantly increased risk of all-cause mortality (HR 2.93) in patients with stable coronary artery disease.
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