Plasma alkaline phosphatase and survival in diabetic patients with acute myocardial infarction

Nunes, José Pedro L.; Melão, Filipa; Godinho, Ana Rita; Rodrigues, José Feliciano; Maciel, Maria Júlia

doi:10.21037/atm.2016.06.01

Cited by 14 publications

(12 citation statements)

References 15 publications

(10 reference statements)

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“…Alkaline phosphatase (ALP) is a generally accepted clinical marker of hepatic or bone disease [ 7 ]. It had been showed that elevated ALP acted as a prognostic indicator of decreased survival in diabetic patients with acute myocardial infarction (MI), possibly in association to decreased renal function in male patients [ 8 ]. At the same time, the combined effect of vascular calcification (VC) and higher ALP was associated with a greater risk of cardiovascular events and death, and high serum ALP increased the risk associated with VC in end-stage kidney disease patients starting dialysis [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Serum alkaline phosphatase levels and the risk of new-onset diabetes in hypertensive adults

Zhang

Zhou

et al. 2020

Cardiovasc Diabetol

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Background The association between alkaline phosphatase (ALP) and incident diabetes remains uncertain. Our study aimed to investigate the prospective relation of serum ALP with the risk of new-onset diabetes, and explore possible effect modifiers, in hypertensive adults. Methods A total 14,393 hypertensive patients with available ALP measurements and without diabetes and liver disease at baseline were included from the China Stroke Primary Prevention Trial (CSPPT). The primary outcome was new-onset diabetes, defined as physician-diagnosed diabetes or use of glucose-lowering drugs during follow-up, or fasting glucose ≥ 7.0 mmol/L at the exit visit. The secondary study outcome was new-onset impaired fasting glucose (IFG), defined as FG < 6.1 mmol/L at baseline and ≥ 6.1 but < 7.0 mmol/L at the exit visit. Results Over a median of 4.5 years follow-up, 1549 (10.8%) participants developed diabetes. Overall, there was a positive relation of serum ALP and the risk of new-onset diabetes (per SD increment, adjusted OR, 1.07; 95% CI: 1.01, 1.14) and new-onset IFG (per SD increment, adjusted OR, 1.07; 95% CI: 1.02, 1.14). Moreover, a stronger positive association between baseline ALP (per SD increment) with new-onset diabetes was found in participants with total homocysteine (tHcy) < 10 μmol/L (adjusted OR, 1.24; 95% CI: 1.10, 1.40 vs. ≥ 10 μmol/L: adjusted OR, 1.03; 95% CI: 0.96, 1.10; P-interaction = 0.007) or FG ≥ 5.9 mmol/L (adjusted OR, 1.16; 95% CI: 1.07, 1.27 vs. < 5.9 mmol/L: adjusted OR, 1.00; 95% CI: 0.93, 1.08; P-interaction = 0.009) Conclusions In this non-diabetic, hypertensive population, higher serum ALP was significantly associated with the increased risk of new-onset diabetes, especially in those with lower tHcy or higher FG levels. Clinical Trial Registration-URL Trial registration: NCT00794885 (clinicaltrials.gov). Retrospectively registered November 20, 2008.

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Section: Introductionmentioning

confidence: 99%

Serum alkaline phosphatase levels and the risk of new-onset diabetes in hypertensive adults

Zhang

Zhou

et al. 2020

Cardiovasc Diabetol

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“…In previous reports, we retrospectively studied data concerning a cohort of diabetic patients with myocardial infarction. 1 , 2 , 3 We now studied the relation between ECG data at admission and survival. Particular attention was paid to the PR interval, since conflicting data exist in the literature concerning the prognostic significance of a prolonged PR interval.…”

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confidence: 99%

“…The present study was retrospective and part of the methods have been described in the previous reports. 1 , 2 The survival of patients was established by the study of electronic health records.…”

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confidence: 99%

“…After a period not inferior to 48 months and up to 61 months after each admission (median 49.2 months, interquartile range 33.1–55.4 months), the retrospective analysis of electronic records showed that 57 of the 193 patients had died (29.7%). 2 The PR interval was evaluated in 170 patients. The median was 169 ms and the interquartile range was 154–190 ms. A negative correlation was seen between the PR interval and heart rate (Pearson correlation coefficient −0.292; significance level <0.001).…”

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confidence: 99%

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PR interval and survival in diabetic patients with acute myocardial infarction

Nunes

Godinho

Rodrigues

et al. 2017

Indian Heart Journal

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“…As indicated by the survival curves for 48 months of follow-up, patients with ALP >74 IU/L had approximately 60% survival compared with 80% in the group with ALP <74 IU/L. 59 In a prospective study involving 1636 patients, where ALP was tested as a biomarker for the survival of patients with MI, a linear correlation was seen between ALP concentrations and mortality in these patients. Moreover, regarding the outcome of pPCI, higher ALP concentrations accurately predicted stent thrombosis as well as the risk of repeat MI.…”

Section: Alkaline Phosphatasementioning

confidence: 97%

The Emerging Role of Bone Markers in Diagnosis and Risk Stratification of Patients With Coronary Artery Disease

et al. 2019

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Molecules that govern bone metabolism, such as osteoprotegerin (OPG) and osteopontin (OPN), have been isolated from other tissues, including blood vessels. Atherosclerosis and coronary artery disease (CAD) are leading causes of mortality worldwide. Despite novel biochemical and imaging techniques, early detection of CAD is still unsatisfactory. Experimental data indicate that bone turnover markers (BTMs) contribute to the development of atherosclerosis. This finding has sparked interest in their clinical use. This narrative review analyzed information from >50 human studies, which strongly suggest that OPG, OPN, and alkaline phosphatase (ALP) serum concentrations are altered in patients with CAD. Osteoprotegerin seems to be more useful for the detection of early disease, while OPN and ALP are recruited in vessels after the establishment of disease. Osteocalcin may be used as a flow cytometry marker for endothelial progenitor cells and can constitute a marker to monitor response to interventional treatments and risk of restenosis. However, most data derive from observational studies. Incorporation of BTMs in multifactorial computational algorithms could further determine their role in CAD diagnosis and prognosis together with other imaging techniques and biochemical markers.

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Plasma alkaline phosphatase and survival in diabetic patients with acute myocardial infarction

Cited by 14 publications

References 15 publications

Serum alkaline phosphatase levels and the risk of new-onset diabetes in hypertensive adults

Serum alkaline phosphatase levels and the risk of new-onset diabetes in hypertensive adults

PR interval and survival in diabetic patients with acute myocardial infarction

The Emerging Role of Bone Markers in Diagnosis and Risk Stratification of Patients With Coronary Artery Disease

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