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Association of De Ritis Ratio with Prognosis in Patients with Coronary Artery Disease and Aminotransferase Activity within and outside the Healthy Values of Reference Range

Background: The aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (De Ritis ratio), obtained from AST and ALT activities in the healthy range, has not been studied in association with mortality. Methods: This study included 3392 patients with stable coronary heart disease and...

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Autores principales: Ndrepepa, Gjin, Cassese, Salvatore, Scalamogna, Maria, Lahu, Shqipdona, Aytekin, Alp, Xhepa, Erion, Schunkert, Heribert, Kastrati, Adnan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10178981/
https://www.ncbi.nlm.nih.gov/pubmed/37176615
http://dx.doi.org/10.3390/jcm12093174
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author Ndrepepa, Gjin
Cassese, Salvatore
Scalamogna, Maria
Lahu, Shqipdona
Aytekin, Alp
Xhepa, Erion
Schunkert, Heribert
Kastrati, Adnan
author_facet Ndrepepa, Gjin
Cassese, Salvatore
Scalamogna, Maria
Lahu, Shqipdona
Aytekin, Alp
Xhepa, Erion
Schunkert, Heribert
Kastrati, Adnan
author_sort Ndrepepa, Gjin
collection PubMed
description Background: The aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (De Ritis ratio), obtained from AST and ALT activities in the healthy range, has not been studied in association with mortality. Methods: This study included 3392 patients with stable coronary heart disease and aminotransferase activity in the reference range. Patients are categorized into two groups: a group with AST and ALT activity in the healthy range (n = 1697), and a group with AST and/or ALT activity outside the healthy range but in the reference range (n = 1695). The primary endpoint was all-cause mortality at three years. Results: The De Ritis ratio (median 5th–95th percentile] was 0.94 [0.61–1.41] in patients with AST and ALT in the healthy range and 0.93 [0.45–1.96] in patients with AST and/or ALT outside the healthy range (p = 0.700). At three years, there were 86 deaths in patients with AST and ALT in the healthy range: 27 deaths (3.9%) in patients with a De Ritis ratio ≤median, and 59 deaths (8.2%) in patients with the De Ritis ratio >median (adjusted hazard ratio [HR] = 1.16, 95% confidence interval [CI] 0.94 to 1.42; p = 0.159); in patients with AST and/or ALT outside the healthy range, there were 148 deaths: 49 deaths (6.6%) in patients with a De Ritis ratio ≤median, and 99 deaths (14.1%) in patients with De Ritis ratio >median (adjusted HR = 1.27 [1.09–1.48], p = 0.002), with both HRs calculated per unit higher values of the De Ritis ratio. Conclusions: The De Ritis ratio obtained from AST and ALT activity in the healthy range was not independently associated with higher risk of mortality. The De Ritis ratio obtained from aminotransferase activity outside the healthy range (but still in the reference range) was independently associated with the risk of mortality.
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spelling pubmed-101789812023-05-13 Association of De Ritis Ratio with Prognosis in Patients with Coronary Artery Disease and Aminotransferase Activity within and outside the Healthy Values of Reference Range Ndrepepa, Gjin Cassese, Salvatore Scalamogna, Maria Lahu, Shqipdona Aytekin, Alp Xhepa, Erion Schunkert, Heribert Kastrati, Adnan J Clin Med Article Background: The aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (De Ritis ratio), obtained from AST and ALT activities in the healthy range, has not been studied in association with mortality. Methods: This study included 3392 patients with stable coronary heart disease and aminotransferase activity in the reference range. Patients are categorized into two groups: a group with AST and ALT activity in the healthy range (n = 1697), and a group with AST and/or ALT activity outside the healthy range but in the reference range (n = 1695). The primary endpoint was all-cause mortality at three years. Results: The De Ritis ratio (median 5th–95th percentile] was 0.94 [0.61–1.41] in patients with AST and ALT in the healthy range and 0.93 [0.45–1.96] in patients with AST and/or ALT outside the healthy range (p = 0.700). At three years, there were 86 deaths in patients with AST and ALT in the healthy range: 27 deaths (3.9%) in patients with a De Ritis ratio ≤median, and 59 deaths (8.2%) in patients with the De Ritis ratio >median (adjusted hazard ratio [HR] = 1.16, 95% confidence interval [CI] 0.94 to 1.42; p = 0.159); in patients with AST and/or ALT outside the healthy range, there were 148 deaths: 49 deaths (6.6%) in patients with a De Ritis ratio ≤median, and 99 deaths (14.1%) in patients with De Ritis ratio >median (adjusted HR = 1.27 [1.09–1.48], p = 0.002), with both HRs calculated per unit higher values of the De Ritis ratio. Conclusions: The De Ritis ratio obtained from AST and ALT activity in the healthy range was not independently associated with higher risk of mortality. The De Ritis ratio obtained from aminotransferase activity outside the healthy range (but still in the reference range) was independently associated with the risk of mortality. MDPI 2023-04-28 /pmc/articles/PMC10178981/ /pubmed/37176615 http://dx.doi.org/10.3390/jcm12093174 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ndrepepa, Gjin
Cassese, Salvatore
Scalamogna, Maria
Lahu, Shqipdona
Aytekin, Alp
Xhepa, Erion
Schunkert, Heribert
Kastrati, Adnan
Association of De Ritis Ratio with Prognosis in Patients with Coronary Artery Disease and Aminotransferase Activity within and outside the Healthy Values of Reference Range
title Association of De Ritis Ratio with Prognosis in Patients with Coronary Artery Disease and Aminotransferase Activity within and outside the Healthy Values of Reference Range
title_full Association of De Ritis Ratio with Prognosis in Patients with Coronary Artery Disease and Aminotransferase Activity within and outside the Healthy Values of Reference Range
title_fullStr Association of De Ritis Ratio with Prognosis in Patients with Coronary Artery Disease and Aminotransferase Activity within and outside the Healthy Values of Reference Range
title_full_unstemmed Association of De Ritis Ratio with Prognosis in Patients with Coronary Artery Disease and Aminotransferase Activity within and outside the Healthy Values of Reference Range
title_short Association of De Ritis Ratio with Prognosis in Patients with Coronary Artery Disease and Aminotransferase Activity within and outside the Healthy Values of Reference Range
title_sort association of de ritis ratio with prognosis in patients with coronary artery disease and aminotransferase activity within and outside the healthy values of reference range
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10178981/
https://www.ncbi.nlm.nih.gov/pubmed/37176615
http://dx.doi.org/10.3390/jcm12093174
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