Alkaline phosphatase-to-albumin ratio as a novel predictor of long-term adverse outcomes in coronary artery disease patients who underwent PCI

Abstract

Background: Alkaline phosphatase (ALP) and albumin (ALB) have been shown to be associated with coronary artery disease (CAD), and it has been reported that alkaline phosphatase-to-albumin ratio (AAR) is associated with the liver damage and poorer prognosis of patients with digestive system malignancy. Moreover, several previous studies showed that there was a higher incidence of malignancy in CAD patients. However, to our knowledge, the relationship between AAR and long-term adverse outcomes in CAD patients after undergoing percutaneous coronary intervention (PCI) has not been investigated. Therefore, we aim to access the relation between AAR and long-term adverse outcomes in post-PCI patients with CAD. Methods: 3378 post-PCI patients with CAD were enrolled in the retrospective CORFCHD-ZZ study from January 2013 to December 2017. The median duration of follow-up was 37.59±22.24 months. The primary endpoint was long-term mortality including all-cause mortality (ACM) and cardiac mortality (CM).The secondary endpoints were major adverse cardiac events (MACEs) and major adverse cardiac and cerebrovascular events (MACCEs). Results: Kaplan-Meier analyses showed that an increased AAR was positively correlated with incidences of long-term ACM (log-rank, P=0.014), CM (log-rank, P=0.011), MACEs (log-rank, P=0.013) and MACCEs (log-rank, P=0.006). Multivariate Cox regression analyses showed that the elevated AAR was an independent predictor of long-term ACM (adjusted HR=1.488 [1.031-2.149], P=0.034), CM (adjusted HR=1.837 [1.141-2.959], P=0.012), MACEs (adjusted HR=1.257 [1.018-1.551], P=0.033) and MACCEs (adjusted HR=1.237 [1.029-1.486], P=0.024). Conclusions: An elevated AAR is a novel independent predictor of long-term adverse outcomes in CAD patients following PCI.

Association between alkaline phosphatase to albumin ratio and mortality among patients with sepsis

“…A similar result was also obtained in non-alcoholic fatty liver disease 38 . In addition, APAR is a good predictor in coronary artery disease patients 13 . And high APAR is related to the outcomes of acute kidney injury 14 .…”

Albumin-to-alkaline phosphatase ratio as a novel prognostic indicator in patients undergoing peritoneal dialysis: a propensity score matching analysis

“…Links between AAPR and cancer were first introduced for hepatocellular carcinoma patients undergoing curative surgery ( 13 ), and subsequent studies showed that, in general, the AAPR can be utilized as a simple indicator in various diseases, such as glioblastoma ( 14 ), coronary artery disease ( 15 ), non-alcoholic fatty liver disease ( 16 ), and renal cell carcinoma ( 17 ). In particular, we recently evaluated the AAPR in critically ill patients with acute kidney injury (AKI) and concluded that AAPR independently predicted OS ( 18 ).…”

AST to ALT ratio as a prospective risk predictor for liver cirrhosis in patients with chronic HBV infection

“…For example, normalized levels of enzymes for a prolonged period are a prompting to discontinue treatment in patients with hepatitis B, autoimmune hepatitis and overlap syndrome [ 12 , 13 ]. AAR value is one main effective hallmark to reflect extent of liver damage and relevant complication [ 14 ], by comprehensively considering the characteristics of AST and ALT released into the blood. According to previous study, AAR was mainly used as a marker to identify fibrosis in patients with NAFLD(non-alcoholic fatty liver disease) [ 15 , 16 ], and performed good discrimination accuracy in advanced alcoholic liver disease (ALD) [ 17 ].…”