Impact of the De Ritis Ratio on the Prognosis of Patients with Stable Coronary Artery Disease Undergoing Percutaneous Coronary Intervention

BACKGROUND: The aim of this study was to emphasize the impact of the aspartate aminotransferase-to-alanine aminotransferase ratio (De Ritis ratio) on the prognosis of patients with stable coronary artery disease (SCAD) undergoing percutaneous coronary intervention (PCI). MATERIAL/METHODS: Patients with SCAD who underwent elective PCI at Shinonoi General Hospital were included. SCAD was defined as epicardial coronary artery diameter stenosis ≥90% or epicardial coronary artery diameter stenosis ≥75% accompanied by symptoms or stress-induced myocardial ischemia. Clinical data were collected, and cardiovascular events were followed after discharge. One-way Cox proportional risk analysis was performed to assess the risk stratification value of the De Ritis ratio, using major adverse cardiac and cerebrovascular events (MACCE) and all-cause mortality as the primary and secondary endpoints, respectively. The independent risk stratification value was evaluated by multivariate Cox proportional risk analysis. RESULTS: Among 204 patients with SCAD undergoing PCI, during a median follow-up period of 706 days (24 months), 13.7% (28/204) patients experienced MACCE, and 8.8% (18/204) experienced all-cause mortality. Multifactorial Cox regression analysis revealed that a high De Ritis ratio was an independent risk factor for MACCE (HR=2.96, 95% CI: 1.29–6.78, P=0.01) and all-cause mortality (HR=3.61, 95% Cl: 1.31–9.86, P=0.012). The sensitivity analysis further confirmed the incremental value of the De Ritis ratio for adverse cardiovascular events. CONCLUSIONS: A high De Ritis ratio was an independent and valuable risk stratification factor for MACCE and all-cause mortality in patients with SCAD after PCI.