title: Preoperative Serum Alkaline Phosphatase and Clinical Outcome of Off-Pump Coronary Artery Bypass Surgery.
abstract: Serum alkaline phosphatase (ALP) is related to vascular calcification. In a recent study on percutaneous coronary intervention (PCI) with a drug-eluting stent, higher ALP was associated with poor clinical outcomes in terms of mortality, myocardial infarction, and stent thrombosis. The aim of this study was to evaluate the relationship between preoperative ALP and clinical outcome of off-pump coronary artery bypass surgery (OPCAB).
  
  
  
  We retrospectively enrolled and reviewed a total of 1,335 patients who underwent OPCAB. Patients were divided into tertiles based on preoperative serum ALP (<60, 60-76, and >76 IU/L). As preoperative ALP increased, the HR of mortality remained constant after adjusting for confounders. On Cox proportional hazards regression analysis, there was no association between ALP and all-cause mortality. The adjusted HR for all-cause mortality for the middle tertile was 0.882 (95% CI: 0.592-1.314, P=0.537), and 0.915 (95% CI: 0.605-1.383, P=0.672) for the highest tertile. In addition, no associations between ALP and cardiovascular mortality, myocardial infarction, revascularization, or major adverse cardiac events were found.
  
  
  
  Unlike after PCI, high ALP is not related to adverse clinical events, such as mortality, myocardial infarction, or revascularization after OPCAB. ALP might be considered when determining the optimal revascularization technique.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital.
authors.forename: Tae Kyong
authors.initials: TK
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital.
authors.forename: Deok Man
authors.initials: DM
authors.lastname: Hong
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital.
authors.forename: Yoon Hyeong
authors.initials: YH
authors.lastname: Choi
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital.
authors.forename: Chang-Hoon
authors.initials: CH
authors.lastname: Koo
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital.
authors.forename: Youn Joung
authors.initials: YJ
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital.
authors.forename: Jun-Bean
authors.initials: JB
authors.lastname: Park
authors.affiliation: Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital.
authors.forename: Kyung Woo
authors.initials: KW
authors.lastname: Park
authors.affiliation: Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital.
authors.forename: Hyo-Soo
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital.
authors.forename: Yunseok
authors.initials: Y
authors.lastname: Jeon
mesh_terms: D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood*; D047549:Coronary Artery Bypass, Off-Pump; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality / Q000601:surgery; D059035:Perioperative Period; D012189:Retrospective Studies
chemical_list: D000469:Alkaline Phosphatase
keywords: Alkaline phosphatase; Clinical outcome; Off-pump coronary artery bypass surgery