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Prognostic impact of alkaline phosphatase measured at time of presentation in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction

BACKGROUND: Serum alkaline phosphatase (ALP) has been shown to be a prognostic factor in several subgroups of patients due to its promotion of vascular calcification. However, the prognostic impact of serum ALP level in ST-segment elevation myocardial infarction (STEMI) patients with a relatively lo...

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Autores principales: Oh, Pyung Chun, Lee, Kyounghoon, Kim, Tae-Hoon, Moon, Jeonggeun, Park, Hyun Woo, Jang, Ho-Jun, Park, Sang-Don, Kwon, Sung Woo, Suh, Jon, Kang, Woong Chol
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300140/
https://www.ncbi.nlm.nih.gov/pubmed/28182682
http://dx.doi.org/10.1371/journal.pone.0171914
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author Oh, Pyung Chun
Lee, Kyounghoon
Kim, Tae-Hoon
Moon, Jeonggeun
Park, Hyun Woo
Jang, Ho-Jun
Park, Sang-Don
Kwon, Sung Woo
Suh, Jon
Kang, Woong Chol
author_facet Oh, Pyung Chun
Lee, Kyounghoon
Kim, Tae-Hoon
Moon, Jeonggeun
Park, Hyun Woo
Jang, Ho-Jun
Park, Sang-Don
Kwon, Sung Woo
Suh, Jon
Kang, Woong Chol
author_sort Oh, Pyung Chun
collection PubMed
description BACKGROUND: Serum alkaline phosphatase (ALP) has been shown to be a prognostic factor in several subgroups of patients due to its promotion of vascular calcification. However, the prognostic impact of serum ALP level in ST-segment elevation myocardial infarction (STEMI) patients with a relatively low calcification burden has not been determined. We aimed to investigate the association of ALP level measured at time of presentation on clinical outcomes in patients with STEMI requiring primary percutaneous coronary intervention (PCI). METHODS: A total of 1178 patients with STEMI undergoing primary PCI between 2007 and 2014 were retrospectively enrolled from the INTERSTELLAR registry and classified into tertiles by ALP level (<64, 65–82, or >83 IU/L). The primary study outcome was a major adverse cardiac or cerebrovascular event (MACCE), defined as the composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, and ischemia-driven revascularization. RESULTS: Median follow-up duration was 25 months (interquartile range, 10–39 months). The incidence of MACCE significantly increased as ALP level increased, that is, for the <64, 65–82, and >83 IU/L tertiles incidences were 8.7%, 11.7%, and 15.7%, respectively; p for trend = 0.003). After adjustment for potential confounders, the adjusted hazard ratios for MACCE in the middle and highest tertiles were 1.69 (95% CI 1.01–2.81) and 2.46 (95% CI 1.48–4.09), respectively, as compared with the lowest ALP tertile. CONCLUSIONS: Elevated ALP level at presentation, but within the higher limit of normal, was found to be independently associated with higher risk of MACCE after primary PCI in patients with STEMI.
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spelling pubmed-53001402017-02-28 Prognostic impact of alkaline phosphatase measured at time of presentation in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction Oh, Pyung Chun Lee, Kyounghoon Kim, Tae-Hoon Moon, Jeonggeun Park, Hyun Woo Jang, Ho-Jun Park, Sang-Don Kwon, Sung Woo Suh, Jon Kang, Woong Chol PLoS One Research Article BACKGROUND: Serum alkaline phosphatase (ALP) has been shown to be a prognostic factor in several subgroups of patients due to its promotion of vascular calcification. However, the prognostic impact of serum ALP level in ST-segment elevation myocardial infarction (STEMI) patients with a relatively low calcification burden has not been determined. We aimed to investigate the association of ALP level measured at time of presentation on clinical outcomes in patients with STEMI requiring primary percutaneous coronary intervention (PCI). METHODS: A total of 1178 patients with STEMI undergoing primary PCI between 2007 and 2014 were retrospectively enrolled from the INTERSTELLAR registry and classified into tertiles by ALP level (<64, 65–82, or >83 IU/L). The primary study outcome was a major adverse cardiac or cerebrovascular event (MACCE), defined as the composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, and ischemia-driven revascularization. RESULTS: Median follow-up duration was 25 months (interquartile range, 10–39 months). The incidence of MACCE significantly increased as ALP level increased, that is, for the <64, 65–82, and >83 IU/L tertiles incidences were 8.7%, 11.7%, and 15.7%, respectively; p for trend = 0.003). After adjustment for potential confounders, the adjusted hazard ratios for MACCE in the middle and highest tertiles were 1.69 (95% CI 1.01–2.81) and 2.46 (95% CI 1.48–4.09), respectively, as compared with the lowest ALP tertile. CONCLUSIONS: Elevated ALP level at presentation, but within the higher limit of normal, was found to be independently associated with higher risk of MACCE after primary PCI in patients with STEMI. Public Library of Science 2017-02-09 /pmc/articles/PMC5300140/ /pubmed/28182682 http://dx.doi.org/10.1371/journal.pone.0171914 Text en © 2017 Oh et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Oh, Pyung Chun
Lee, Kyounghoon
Kim, Tae-Hoon
Moon, Jeonggeun
Park, Hyun Woo
Jang, Ho-Jun
Park, Sang-Don
Kwon, Sung Woo
Suh, Jon
Kang, Woong Chol
Prognostic impact of alkaline phosphatase measured at time of presentation in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction
title Prognostic impact of alkaline phosphatase measured at time of presentation in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction
title_full Prognostic impact of alkaline phosphatase measured at time of presentation in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction
title_fullStr Prognostic impact of alkaline phosphatase measured at time of presentation in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction
title_full_unstemmed Prognostic impact of alkaline phosphatase measured at time of presentation in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction
title_short Prognostic impact of alkaline phosphatase measured at time of presentation in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction
title_sort prognostic impact of alkaline phosphatase measured at time of presentation in patients undergoing primary percutaneous coronary intervention for st-segment elevation myocardial infarction
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300140/
https://www.ncbi.nlm.nih.gov/pubmed/28182682
http://dx.doi.org/10.1371/journal.pone.0171914
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