Key result
AST/ALT ratio ≥0.9 is linked to severely impaired LVEF in patients with HFrEF.
Why the study?
There has been limited research evaluating the predictive value of AST/ALT ratio in patients with chronic heart failure with reduced left ventricular ejection fraction.
Does the AST/ALT ratio predict the functional severity of chronic heart failure with reduced left ventricular ejection fraction?
Cross-Sectional (n=105)
No
Does the AST/ALT ratio predict the functional severity of chronic heart failure with reduced left ventricular ejection fraction?
Effect estimate: AUC 0.64 (95% CI 0.54-0.73)
p-value: p=<0.05
The AST/ALT ratio is a simple, accessible biomarker that correlates with functional severity and echocardiographic parameters in patients with HFrEF.
AST/ALT ratio may aid HFrEF severity stratification; hypothesis-generating and requires prospective validation before clinical use.
OBJECTIVE: Despite previous research that focused on liver transaminases as predictors of cardiovascular disease, there has been limited research evaluating the predictive value of AST/ALT ratio in patients with heart failure. We aimed to investigate AST/ALT ratio as an indicator of the functional severity in chronic heart failure with reduced left ventricular ejection fraction. RESULTS: Overall, 105 patients previously diagnosed with HFrEF from Buraidah-Al Qassim province, Saudi Arabia were included in this retrospective cross-sectional study. Data on study variables, including demographic data, left ventricular ejection fraction, NYHA class, and AST/ALT ratio, were collected from patients' records. The patients were divided into two groups, namely group-1 (AST/ALT ratio < 1) and group-2 (AST/ALT ratio ≥ 1), to identify any differences in their cardiac function profiles. NYHA class and NT-proBNP were higher and LVEF was lower in group-2 than in group-1. We found a mild significant correlation between AST/ALT ratio and APRI, FIB-4 score, NYHA-class, and LVEF (r = 0.2, 0.25, 0.26, and - 0.24, respectively; P < 0.05). Multivariate linear regression analysis model and ROC curve showed that AST/ALT ratio could independently predict HFrEF functional severity with a best cut-off value of 0.9, sensitivity of 43.6%, and specificity of 81.4%.
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Ewid et al. (2020) conducted a cross-sectional in Chronic heart failure with reduced left ventricular ejection fraction (HFrEF) (n=105). AST/ALT ratio vs. AST/ALT ratio < 1 was evaluated on Prediction of severely impaired LVEF (LVEF < 30%) (AUC 0.64, 95% CI 0.54-0.73, p=<0.05). An AST/ALT ratio cut-off of 0.9 independently predicted severely impaired left ventricular ejection fraction (<30%) in patients with HFrEF, with an area under the curve of 0.64, sensitivity of 43.6%, and specificity of 81.4%.
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