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Markedly Elevated Aspartate Aminotransferase from Non-Hepatic Causes

There have been no reports on mortality in patients with markedly elevated aspartate aminotransferase (AST) levels from non-hepatic causes to date. This study aimed to determine the etiologies of markedly elevated AST levels > 400 U/L due to non-hepatic causes and to investigate the factors assoc...

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Autores principales: Han, Ji-Hee, Kwak, Ji-Yoon, Lee, Sang-Soo, Kim, Hyun-Gyu, Jeon, Hankyu, Cha, Ra-Ri
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821092/
https://www.ncbi.nlm.nih.gov/pubmed/36615110
http://dx.doi.org/10.3390/jcm12010310
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author Han, Ji-Hee
Kwak, Ji-Yoon
Lee, Sang-Soo
Kim, Hyun-Gyu
Jeon, Hankyu
Cha, Ra-Ri
author_facet Han, Ji-Hee
Kwak, Ji-Yoon
Lee, Sang-Soo
Kim, Hyun-Gyu
Jeon, Hankyu
Cha, Ra-Ri
author_sort Han, Ji-Hee
collection PubMed
description There have been no reports on mortality in patients with markedly elevated aspartate aminotransferase (AST) levels from non-hepatic causes to date. This study aimed to determine the etiologies of markedly elevated AST levels > 400 U/L due to non-hepatic causes and to investigate the factors associated with mortality in these cases. This retrospective study included 430 patients with AST levels > 400 U/L unrelated to liver disease at two centers between January 2010 and December 2021. Patients were classified into three groups according to etiology: skeletal muscle damage, cardiac muscle damage, and hematologic disorder. Binary logistic regression analysis was performed to evaluate the factors associated with 30-day mortality. The most common etiology for markedly elevated AST levels was skeletal muscle damage (54.2%), followed by cardiac muscle damage (39.1%) and hematologic disorder (6.7%). The 30-day mortality rates for the skeletal muscle damage, cardiac muscle damage, and hematologic disorder groups were 14.2%, 19.5%, and 65.5%, respectively. The magnitude of the peak AST level significantly correlated with 30-day mortality, with rates of 12.8%, 26.7%, and 50.0% for peak AST levels < 1000 U/L, <3000 U/L, and ≥3000 U/L, respectively. In the multivariate analysis, cardiac muscle damage (odds ratio [OR] = 2.76, 95% confidence interval [CI] = 1.31–5.80), hematologic disorder (OR = 9.47, 95% CI = 2.95–30.39), peak AST < 3000 U/L (OR = 2.94, 95% CI = 1.36–6.35), and peak AST ≥ 3000 U/L (OR = 9.61, 95% CI = 3.54–26.08) were associated with increased 30-day mortality. Our study revealed three etiologies of markedly elevated AST unrelated to liver disease and showed that etiology and peak AST level significantly affected the survival rate.
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spelling pubmed-98210922023-01-07 Markedly Elevated Aspartate Aminotransferase from Non-Hepatic Causes Han, Ji-Hee Kwak, Ji-Yoon Lee, Sang-Soo Kim, Hyun-Gyu Jeon, Hankyu Cha, Ra-Ri J Clin Med Article There have been no reports on mortality in patients with markedly elevated aspartate aminotransferase (AST) levels from non-hepatic causes to date. This study aimed to determine the etiologies of markedly elevated AST levels > 400 U/L due to non-hepatic causes and to investigate the factors associated with mortality in these cases. This retrospective study included 430 patients with AST levels > 400 U/L unrelated to liver disease at two centers between January 2010 and December 2021. Patients were classified into three groups according to etiology: skeletal muscle damage, cardiac muscle damage, and hematologic disorder. Binary logistic regression analysis was performed to evaluate the factors associated with 30-day mortality. The most common etiology for markedly elevated AST levels was skeletal muscle damage (54.2%), followed by cardiac muscle damage (39.1%) and hematologic disorder (6.7%). The 30-day mortality rates for the skeletal muscle damage, cardiac muscle damage, and hematologic disorder groups were 14.2%, 19.5%, and 65.5%, respectively. The magnitude of the peak AST level significantly correlated with 30-day mortality, with rates of 12.8%, 26.7%, and 50.0% for peak AST levels < 1000 U/L, <3000 U/L, and ≥3000 U/L, respectively. In the multivariate analysis, cardiac muscle damage (odds ratio [OR] = 2.76, 95% confidence interval [CI] = 1.31–5.80), hematologic disorder (OR = 9.47, 95% CI = 2.95–30.39), peak AST < 3000 U/L (OR = 2.94, 95% CI = 1.36–6.35), and peak AST ≥ 3000 U/L (OR = 9.61, 95% CI = 3.54–26.08) were associated with increased 30-day mortality. Our study revealed three etiologies of markedly elevated AST unrelated to liver disease and showed that etiology and peak AST level significantly affected the survival rate. MDPI 2022-12-30 /pmc/articles/PMC9821092/ /pubmed/36615110 http://dx.doi.org/10.3390/jcm12010310 Text en © 2022 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
Han, Ji-Hee
Kwak, Ji-Yoon
Lee, Sang-Soo
Kim, Hyun-Gyu
Jeon, Hankyu
Cha, Ra-Ri
Markedly Elevated Aspartate Aminotransferase from Non-Hepatic Causes
title Markedly Elevated Aspartate Aminotransferase from Non-Hepatic Causes
title_full Markedly Elevated Aspartate Aminotransferase from Non-Hepatic Causes
title_fullStr Markedly Elevated Aspartate Aminotransferase from Non-Hepatic Causes
title_full_unstemmed Markedly Elevated Aspartate Aminotransferase from Non-Hepatic Causes
title_short Markedly Elevated Aspartate Aminotransferase from Non-Hepatic Causes
title_sort markedly elevated aspartate aminotransferase from non-hepatic causes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821092/
https://www.ncbi.nlm.nih.gov/pubmed/36615110
http://dx.doi.org/10.3390/jcm12010310
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