Hypoxic Liver Injury at Admission as a Predictor of In-hospital Death in Patients with ST-Elevation Myocardial Infarction (STEMI) undergone Primary percutaneous coronary intervention (PCI): Data from INTERSTELLAR cohort

초록

Background Recently, hypoxic liver injury (HLI) has been proposed as a novel prognostic marker for ST-elevation myocardial infarction(STEMI) in small study.So, we evaluated the prognostic implication of HLI at admission in patients with STEMI who underwent primary percutaneous coronary intervention (PCI) in large cohort. Method From 2007 to 2014, a total of 1540consecutive patients (1221 males, mean age 61±13 years old)with STEMI underwent primary PCIwere analyzed retrospectively. HLI was defined as ≥ 2-fold increase of serum alanine aminotransferase (ALT) above upper normal limitat the time of presentation.Primary endpoint was in-hospital death. Results Of all patients, the HLI was noted in 7.7% patients. Compared to patients without HLI, the patients with HLI were younger (58±14 vs. 61±13 years, p=0.043), had lower ejection fraction (43±15 vs. 48±17%, p=0.002). A total of 89 in-hospital death(5.8%)were occurred.Compared to patients without in-hospital death, those patientswere older (69±11 vs. 60±13 years old, p<0.001), had higher ALT (65±69 vs. 36±40 IU/L,p<0.001) at the time of presentation and had lower left ventricular ejection fraction (49±12 vs.27±19, p<0.001). The HLI at the presentation was associated with high in-hospital death (p <0.001) and was an independent predictor of in-hospital death (HR5.69, CI 3.12&#8211;10.38, p<0.001) after adjusted by age, diabetes, sex and shock. Conclusion The HLIisan independent predictor of in-hospital death in patients with STEMI underwent primary PCI.