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Prognostic significance of transaminases after acute ST-elevation myocardial infarction: insights from a cardiac magnetic resonance study

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Summary

Background

In patients with ST-elevation myocardial infarction (STEMI), the relationship between transaminases and myocardial damage detected by cardiac magnetic resonance (CMR) imaging is unknown and the prognostic value incompletely investigated.

Materials and methods

CMR imaging was performed in 167 STEMI patients 2.3 [1.6–3.9] days after primary percutaneous coronary intervention (PPCI). Blood samples for transaminase measurement (aspartate transaminase (AST) and alanine transaminase (ALT)) were obtained serially from day 1 to day 4 after PPCI. Patients were followed for major adverse cardiac events (MACE) for 2.7 [1.1–3.3] years.

Results

Admission and peak concentrations of AST and ALT were significantly associated with ejection fraction (p < 0.001), infarct size (p < 0.001), and the presence of microvascular obstruction (p < 0.01). Peak values of both transaminases showed a stronger correlation with CMR parameters than admission values (all p < 0.05). In Kaplan–Meier analysis, a high peak AST or high peak ALT was associated with reduced MACE-free survival (both p < 0.01), whereas admission values were not (both p > 0.05). Peak AST (hazard ratio (HR): 4.93 [1.70–14.32], p = 0.003) and peak ALT (HR: 5.67 [1.94–16.56], p = 0.002) were independent predictors of MACE after adjusting for clinical risk factors.

Conclusions

Transaminases measured in the acute phase after PPCI for STEMI are associated with systolic dysfunction, more extensive myocardial necrosis and microvascular injury with subsequent prognostic information on MACE at long-term follow-up.

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Authors and Affiliations

  1. University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria

    Sebastian J. Reinstadler MD, Martin Reindl MD, Hans-Josef Feistritzer MD, Gert Klug MD, Alexander Minh-Duc Tu MD, Luc Huybrechts MD, Johannes Mair MD, Wolfgang-Michael Franz MD & Bernhard Metzler MD, MSc

  2. Department of Radiology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria

    Agnes Mayr MD

  3. Department of Cardiac Surgery, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria

    Markus Kofler MD

Authors
  1. Sebastian J. Reinstadler MD
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  2. Martin Reindl MD
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  3. Hans-Josef Feistritzer MD
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  4. Gert Klug MD
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  5. Agnes Mayr MD
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  6. Markus Kofler MD
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  7. Alexander Minh-Duc Tu MD
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  8. Luc Huybrechts MD
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  9. Johannes Mair MD
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  10. Wolfgang-Michael Franz MD
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  11. Bernhard Metzler MD, MSc
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Corresponding author

Correspondence to Bernhard Metzler MD, MSc.

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Reinstadler, S., Reindl, M., Feistritzer, HJ. et al. Prognostic significance of transaminases after acute ST-elevation myocardial infarction: insights from a cardiac magnetic resonance study. Wien Klin Wochenschr 127, 843–850 (2015). https://doi.org/10.1007/s00508-015-0868-6

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  • DOI: https://doi.org/10.1007/s00508-015-0868-6

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