title: Liver and cholestatic parameters as prognostic biomarkers of in-hospital MACE in patients with STEMI.
abstract: BACKGROUND
  Liver and cholestatic parameters are increased in ST-segment elevation myocardial infarction (STEMI). The aim of the present study was to evaluate the prognostic value of these parameters to predict in-hospital major adverse cardiac events (MACE) in patients after STEMI.
  
  
  METHODS
  Blood samples of patients with STEMI, who underwent percutaneous coronary intervention (PCI) and stent implantation, were retrospectively analysed and correlated with in-hospital events.
  
  
  RESULTS
  The study population consisted of 847 consecutive patients (62·4 ± 13·43 years; 73·8% male). The total in-hospital MACE rate was 9·8%, driven by death of any cause (8·4%). The Mann-Whitney U-test revealed that liver and cholestatic parameters (alanine transaminase P < 0·0001, aspartate transaminase P < 0·0001, alkaline phosphatase (AP) P < 0·0001, gamma-glutamyl transferase P = 0·0006 and total bilirubin P = 0·0023) were significantly higher in the MACE group. Further logistic regression analyses confirmed the correlation between MACE and all five laboratory markers, even after adjustment for age and heart enzymes. Logistic regression model revealed AP to be the best predictor for worth outcome (OR 1·0188; 95% CI 1·0118-1·0258; P < 0·0001).
  
  
  CONCLUSIONS
  Liver and cholestatic parameters are elevated in patients after STEMI. Increased AP is associated with in-hospital event rates.
authors.affiliation: First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany.
authors.forename: Aydin
authors.initials: A
authors.lastname: Huseynov
authors.affiliation: First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Baumann
authors.affiliation: First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Becher
authors.affiliation: First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany.
authors.forename: Johanna
authors.initials: J
authors.lastname: Koepp
authors.affiliation: First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany.
authors.forename: Siegfried
authors.initials: S
authors.lastname: Lang
authors.affiliation: First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany.
authors.forename: Claude
authors.initials: C
authors.lastname: Jabbour
authors.affiliation: First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Behnes
authors.affiliation: First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Borggrefe
authors.affiliation: First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Akin
mesh_terms: D015415:Biomarkers; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology; D004798:Enzymes / Q000378:metabolism; D005260:Female; D006801:Humans; D007902:Length of Stay; D008099:Liver / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D012189:Retrospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000503:physiopathology / Q000601:surgery*; D015607:Stents; D013318:Stroke Volume / Q000502:physiology
chemical_list: D015415:Biomarkers; D004798:Enzymes
keywords: Alkaline phosphatase; ST elevation myocardial infarction; liver; major adverse cardiac events; percutaneous coronary intervention