Key result
An AST/ALT ratio >2 was significantly associated with a higher prevalence of total vessel occlusion (TIMI thrombus grade 5) in STEMI patients undergoing primary PCI.
Why the study?
Elevated blood transaminase levels are frequently detected in myocardial infarction, but the predictive value of the AST/ALT ratio in assessing coronary thrombus burden severity in STEMI patients undergoing primary PCI was unknown.
Does an AST/ALT ratio greater than 2 predict high coronary thrombus burden in patients with STEMI undergoing primary PCI?
Cohort (n=115)
Does an AST/ALT ratio greater than 2 predict high coronary thrombus burden in patients with STEMI undergoing primary PCI?
An AST/ALT ratio greater than 2 is a strong predictor of high coronary thrombus burden (TIMI grade 5) in patients with STEMI undergoing primary PCI.
AST/ALT ratio may aid thrombus burden assessment in STEMI; leaves open incremental prognostic value beyond standard markers.
Background and aim The liver is extremely responsive to circulatory hemodynamics as a result of its intricate network of blood arteries. Elevated blood transaminase levels are frequently detected in individuals with myocardial infarction, this study is to determine the predictive value of the aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio and different clinical parameters in assessing the severity of coronary thrombus burden in patients with ST-elevation myocardial infarction (STEMI) undergoing primary PCI. Patients and methods This is a prospective cohort study conducted on 115 patients with acute STEMI (ST segment myocardial infarction) who underwent primary PCI. AST/ALT ratio was calculated for each patient. Evaluation of the extent of thrombus burden using the thrombolysis in myocardial infarction (TIMI) scoring system. Results 56 patients had AST/ALT ratio greater than 2, while 59 patients had AST/ALT ratio less than 2. STEMI patients with AST/ALT ratio greater than 2 had a significantly higher prevalence of total vessel occlusion (TIMI thrombus grade 5), and there is a significant association between high AST/ALT ratio and TIMI thrombus grade 5 on both univariate and multivariate analysis. However, there is no statistically significant difference between both groups as regarding the coronary artery complexity as assessed by SYNTAX and Genseni scores. Conclusion Patients with AST/ALT ratio greater than 2 are strongly associated with high thrombus burden (thrombus burden of 5) on TIMI thrombus grade before primary PCI.
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Aboelhassan et al. (2024) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=115). AST/ALT ratio > 2 vs. AST/ALT ratio < 2 was evaluated on Total vessel occlusion (TIMI thrombus grade 5). An AST/ALT ratio >2 was significantly associated with a higher prevalence of total vessel occlusion (TIMI thrombus grade 5) in STEMI patients undergoing primary PCI.
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