Aspartate aminotransferase and mortality in patients with ischemic heart disease.

Ndrepepa, Gjin; Holdenrieder, Stefan; Cassese, Salvatore; Xhepa, Erion; Fusaro, Massimiliano; Laugwitz, Karl-Ludwig; Schunkert, Heribert; Kastrati, Adnan

doi:10.1016/j.numecd.2020.07.033

2020

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Title:: Aspartate aminotransferase and mortality in patients with ischemic heart disease.
Document type:: Article; Journal Article
Author(s):: Ndrepepa, Gjin; Holdenrieder, Stefan; Cassese, Salvatore; Xhepa, Erion; Fusaro, Massimiliano; Laugwitz, Karl-Ludwig; Schunkert, Heribert; Kastrati, Adnan
Abstract:: BACKGROUND AND AIMS: Evidence on the association between aspartate aminotransferase (AST) activity and mortality of patients with ischemic heart disease (IHD) is limited. We investigated whether there is an association between AST activity and mortality in IHD patients. METHODS AND RESULTS: The study included 6857 patients with coronary angiography-proven IHD and AST activity within the reference range. AST activity measurements were available in all patients. The primary outcome was 3-year cardiac mortality. Patients were categorized in groups according to the AST activity tertiles: a group with AST within the 1st tertile (AST < 17.0 U/L), a group with AST within the 2nd tertile (AST > 17-24.5 U/L) and a group with AST within the 3rd tertile (AST > 24.5 U/L). Cardiac death (n = 297) occurred in 109, 69 and 119 patients in the 1st to 3rd AST tertiles (Kaplan-Meier estimates of mortality: 5.3%, 3.6% and 5.9%; univariable hazard ratio [HR] = 1.75, 95% confidence interval [CI] 1.30-2.36, P < 0.001 for tertile 3 vs. 2; HR = 1.13 [0.87-1.46], P = 0.370 for tertile 3 vs. 1; and HR = 0.65 [0.48-0.87], P = 0.004 for tertile 2 vs. 1). The association between AST and cardiac mortality was U-shaped. AST values <15 U/L (HR = 1.118 [1.009-1.238]) and >23 U/L (HR = 1.029 [1.003-1.056]) were associated with higher cardiac mortality compared with the reference value (21 U/L). After adjustment, the association between AST and cardiac mortality was attenuated (P = 0.133) but remained non-linear (P = 0.047). CONCLUSIONS: In patients with IHD, AST activity was associated with the risk of cardiac mortality with a U-shaped relationship. After adjustment, the association between AST and mortality was attenuated.
Journal title abbreviation:: Nutr Metab Cardiovasc Dis
Year:: 2020
Journal volume:: 30
Journal issue:: 12
Pages contribution:: 2335-2342
Fulltext / DOI:: doi:10.1016/j.numecd.2020.07.033
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/32917497
Print-ISSN:: 0939-4753
TUM Institution:: I. Medizinische Klinik und Poliklinik (Kardiologie); Institut für Laboratoriumsmedizin (keine SAP-Zuordnung!); Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert)
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