Prognostic impact of preoperative serum alkaline phosphatase level on a composite of morbidity and mortality after thoracic endovascular aortic repair

Abstract

Background:Serum alkaline phosphatase (ALP) is related to vascular calcification and is known to have a prognostic impact in various cohorts. However, evidence in patients undergoing thoracic endovascular aortic repair (TEVAR) is lacking. Thus, we hypothesized that preoperative serum ALP level could be used for predicting adverse events after TEVAR.Methods:We retrospectively reviewed 167 patients who underwent TEVAR between February 2013 and December 2016. Patients were classified into tertiles according to preoperative ALP level (<69, 69–92, and >92 IU/L). The composite of morbidity and mortality (composite MM) was defined as the presence of one or more of the following: myocardial infarction, cerebrovascular accident, dialysis requirement, pulmonary complication, infection, and mortality within 1 year after TEVAR. The incidence of composite MM was compared among the 3 tertiles, and stepwise logistic regression analysis was performed to evaluate the predictors for composite MM.Results:The incidence of composite MM was 14.5% in the first tertile group, 17.9% in the second tertile group, and 35.7% in the third tertile group (P = .016). The third tertile of ALP level (odds ratio [OR] 1.766, 95% confidence interval [CI] 1.074–2.904, P = .025) and emergency TEVAR (OR 2.369, 95% CI 1.050–5.346, P = .038) remained as independent predictors of composite MM.Conclusions:Our data showed an independent relationship between high preoperative ALP levels and adverse outcomes in patients undergoing TEVAR. This finding might suggest a potential role of ALP level as a risk stratification marker.

Fibro‐osseous Lesions of Paranasal Sinus and Craniofacial Region: A Retrospective Study of 282 Cases

“…The serum ALP level not only serve as a biomarker of bone disease, but also shows predictive power for prognosis in patients with kidney disease, myocardial infarction, stroke, and even in the general population 25–27 . Therefore, it is routinely checked for a comprehensive laboratory evaluation before surgery in our hospital.…”

“…The serum ALP level not only serve as a biomarker of bone disease, but also shows predictive power for prognosis in patients with kidney disease, myocardial infarction, stroke, and even in the general population. [25][26][27] Therefore, it is routinely checked for a comprehensive laboratory evaluation before surgery in our hospital. In this study, both the preoperative serum ALP levels of OF and FD were higher than that of osteoma, which is considered to be related to younger OF and FD patients than osteoma patients.…”