title: In Acute Myocardial Infarction Liver Parameters Are Associated With Stenosis Diameter.
abstract: Detection of high-risk subjects in acute myocardial infarction (AMI) by noninvasive means would reduce the need for intracardiac catheterization and associated complications. Liver enzymes are associated with cardiovascular disease risk. A potential predictive value for liver serum markers for the severity of stenosis in AMI was analyzed.Patients with AMI undergoing percutaneous coronary intervention (PCI; n = 437) were retrospectively evaluated. Minimal lumen diameter (MLD) and percent stenosis diameter (SD) were determined from quantitative coronary angiography. Patients were classified according to the severity of stenosis (SD ≥ 50%, n = 357; SD < 50%, n = 80). Routine heart and liver parameters were associated with SD using random forests (RF). A prediction model (M10) was developed based on parameter importance analysis in RF.Age, alkaline phosphatase (AP), aspartate aminotransferase (AST), and MLD differed significantly between SD ≥ 50 and SD < 50. Age, AST, alanine aminotransferase (ALT), and troponin correlated significantly with SD, whereas MLD correlated inversely with SD. M10 (age, BMI, AP, AST, ALT, gamma-glutamyltransferase, creatinine, troponin) reached an AUC of 69.7% (CI 63.8-75.5%, P < 0.0001).Routine liver parameters are associated with SD in AMI. A small set of noninvasively determined parameters can identify SD in AMI, and might avoid unnecessary coronary angiography in patients with low risk. The model can be accessed via http://stenosis.heiderlab.de.
authors.affiliation: From the Department for Cardiology, West German Heart and Vascular Centre Essen, University Hospital, University Duisburg-Essen, Essen, Germany (TB, MJ, SH, RE); Department of Bioinformatics, Straubing Center of Science, University of Applied Science Weihenstephan-Triesdorf, Straubing, Germany (UN, MR, DH); and Department of Gastroenterology and Hepatology, University Hospital, University Duisburg-Essen (J-PS, JK, GG, AC), Essen, Germany.
authors.forename: Theodor
authors.initials: T
authors.lastname: Baars
authors.forename: Ursula
authors.initials: U
authors.lastname: Neumann
authors.forename: Mona
authors.initials: M
authors.lastname: Jinawy
authors.forename: Stefanie
authors.initials: S
authors.lastname: Hendricks
authors.forename: Jan-Peter
authors.initials: JP
authors.lastname: Sowa
authors.forename: Julia
authors.initials: J
authors.lastname: Kälsch
authors.forename: Mona
authors.initials: M
authors.lastname: Riemenschneider
authors.forename: Guido
authors.initials: G
authors.lastname: Gerken
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
authors.forename: Dominik
authors.initials: D
authors.lastname: Heider
authors.forename: Ali
authors.initials: A
authors.lastname: Canbay
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000473:pathology*; D004798:Enzymes / Q000097:blood; D005260:Female; D006801:Humans; D008099:Liver / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000000981:diagnostic imaging / Q000473:pathology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D004798:Enzymes