Ndrepepa Gjin, Holdenrieder Stefan, Kastrati Adnan
Deutsches Herzzentrum München, Technical University of Munich, Munich, Germany.
Institut für Laboratoriumsmedizin, Deutsches Herzzentrum München, Technical University of Munich, Munich, Germany.
Clin Chim Acta. 2022 Oct 1;535:75-81. doi: 10.1016/j.cca.2022.08.016. Epub 2022 Aug 17.
The association between aspartate aminotransferase to alanine aminotransferase ratio (De Ritis ratio) and prognosis of patients with acute myocardial infarction (AMI) remains poorly investigated.
This study included 3000 patients with AMI undergoing percutaneous coronary intervention. Patients were categorized in groups according to tertiles of the De Ritis ratio: tertile 1 (De Ritis ratio < 1.11; 905 patients), tertile 2 (De Ritis ratio 1.11 to 1.95; 1003 patients) and tertile 3 (De Ritis ratio > 1.95; 1002 patients). The primary endpoint was 3-year all-cause mortality.
At 3 years, all-cause deaths occurred in 487 patients: 119 deaths (13.2%) in patients of 1st tertile, 164 deaths (17.8%) in patients of 2nd tertile and 204 deaths (21.9%) in patients of 3rd tertile of the De Ritis ratio (adjusted hazard ratio [HR] = 1.16, 95% confidence interval [CI] 1.02 to 1.31], P = 0.023 per unit increment in the logarithmic scale of the De Ritis ratio); cardiac deaths occurred in 328 patients: 76 deaths (8.2%) in patients of 1st tertile, 110 deaths (12.0%) in patients of 2nd tertile and 142 deaths (15.4%) in patients of 3rd tertile of the De Ritis ratio (adjusted HR = 1.20 [1.04-1.40], P = 0.014 per unit increment in the logarithmic scale of De Ritis ratio). The C-statistic of the multivariable model(s) with baseline data without and with De Ritis ratio was 0.822 [0.805-0.839] and 0.823 [0.805-0.840], (P = 0.419) for all-cause mortality and 0.831[0.811-0.852] and 0.832 [0.811-0.853], P = 0.621) for cardiac mortality.
In patients with AMI, elevated De Ritis ratio was associated with increased risk of 3-year mortality.
天冬氨酸氨基转移酶与丙氨酸氨基转移酶比值（德瑞蒂斯比值）与急性心肌梗死（AMI）患者预后之间的关联仍未得到充分研究。
本研究纳入了3000例行经皮冠状动脉介入治疗的AMI患者。根据德瑞蒂斯比值的三分位数将患者分为三组：第一三分位数（德瑞蒂斯比值<1.11；905例患者）、第二三分位数（德瑞蒂斯比值1.11至1.95；1003例患者）和第三三分位数（德瑞蒂斯比值>1.95；1002例患者）。主要终点为3年全因死亡率。
3年时，487例患者发生全因死亡：德瑞蒂斯比值第一三分位数的患者中有119例死亡（13.2%），第二三分位数的患者中有164例死亡（17.8%），第三三分位数的患者中有204例死亡（21.9%）（德瑞蒂斯比值对数尺度每增加一个单位，校正风险比[HR]=1.16，95%置信区间[CI]1.02至1.31，P=0.023）；328例患者发生心源性死亡：德瑞蒂斯比值第一三分位数的患者中有76例死亡（8.2%），第二三分位数的患者中有110例死亡（12.0%），第三三分位数的患者中有142例死亡（15.4%）（德瑞蒂斯比值对数尺度每增加一个单位，校正HR=1.20[1.04 - 1.40]，P=0.014）。包含和不包含德瑞蒂斯比值的基线数据的多变量模型的C统计量，全因死亡率分别为0.822[0.805 - 0.839]和0.823[0.805 - 0.840]，（P=0.419），心源性死亡率分别为0.831[0.811 - 0.852]和0.832[0.811 - 0.853]，P=0.621）。
在AMI患者中，德瑞蒂斯比值升高与3年死亡风险增加相关。
