Alanine aminotransferase levels and monocyte count independently predict 30-day outcomes in st-elevation myocardial infarction patients with successfully restored coronary TIMI-3 flow by primary percutaneous coronary intervention

Abstract

Aim: To investigate the relationship of various hematological and biochemical parameters besides the cardiac enzymes with 30-day outcomes in patients with successfully restored coronary TIMI-3 flow by primary percutaneous coronary intervention (p-PCI). Materials and methods: Two hundred patients with ST elevation myocardial infarction (STEMI), with no history of prior myocardial infarction (MI), who underwent p-PCI and had TIMI-3 flow, were enrolled, consecutively. The primary endpoint of the study was defined as the composite of death, fatal and non-fatal MI, target vessel revascularization and cerebrovascular event. Results: Only ALT concentration (OR: 1.010, 95% CI: 1.003-1.018, P = 0.008), monocyte count (OR: 1.002, 95% CI: 1.001 - 1.004, P = 0.005), hypertension (OR: 3.010, 95% CI: 1.081 - 8.384, p = 0.035) and lower LVEF (OR: 0.926, 95% CI: 0.875 - 0.981, P = 0.008) were independent predictors of primary endpoint in multivariate logistic regression analysis. Conclusion: We found that elevated liver enzymes as determined by serum Alanine aminotransferase levels and monocyte count as well as hypertension and lower LVEF independently predicted 30-day outcomes in patients with successfully restored coronary flow by p-PCI. These parameters may provide new aspects, to identify the pathophysiology and prognosis of acute vascular events, which in turn may facilitate discovery of new treatment modalities. © 2012 Düzce Medical Journal.