Department of Heart Center, the First Hospital of Hebei Medicical University, 89Donggang Road, Shijiazhuang, 050000, Hebei, China.
Graduate School of Hebei Medical University, 361 Zhongshan East Road, Shijiazhuang, 050000, Hebei, China.
Sci Rep. 2023 Oct 20;13(1):17974. doi: 10.1038/s41598-023-45246-5.
The occurrence of heart failure following acute myocardial infarction (AMI) significantly increases the risk of post-infarction mortality. Alkaline phosphatase (AP) is considered to be an independent predictor of cardiovascular disease (CVD) and adverse outcomes. Furthermore, in recent years, alkaline phosphatase has been associated with insulin resistance (IR). Our aim was to investigate the correlation between IR substitutes (triglyceride-glucose (TyG) index, triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio), AP, and LV dysfunction in patients admitted after AMI. The retrospective study included 810 patients who underwent coronary angiography for myocardial infarction at the First Hospital of Hebei Medical University from August 2018 to December 2021. Patients were categorized into three groups based on their serum AP levels. Clinical characteristics at admission, cardiac echocardiography findings, coronary angiography results, and biochemical markers such as serum AP levels and triglycerides (TG) were recorded during hospitalization. Left ventricular ejection fraction (LVEF) was assessed using cardiac echocardiography conducted from the time of admission until the coronary angiography procedure. A total of 774 patients with AMI were included in this study. The TyG index is significantly correlated with the TG/HDL-C ratio. (R = 0.739, P < 0.001). Binary logistic regression analysis revealed that elevated serum AP (OR 2.598, 95% CI 1.331-5.071, P = 0.005), presence of the left anterior descending (LAD) artery as the infarct-related artery (IRA) (OR 2.452, 95% CI 1.352-4.449, P = 0.003), and triglyceride (TG) levels (OR 0.652, 95% CI 0.429-0.992, P = 0.046) were protective risk factor for an admission LVEF < 40% following AMI. The serum alkaline phosphatase and LAD as IRA are independent risk factors for severe reduction in LVEF during hospitalization for AMI. Conversely, triglyceride are independent protective factor for severe reduction in LVEF during AMI hospitalization.
心肌梗死后心力衰竭的发生显著增加了梗死后死亡率。碱性磷酸酶（AP）被认为是心血管疾病（CVD）和不良结局的独立预测因子。此外，近年来，碱性磷酸酶与胰岛素抵抗（IR）有关。我们的目的是探讨急性心肌梗死后入院患者的 IR 替代物（甘油三酯-葡萄糖（TyG）指数、甘油三酯与高密度脂蛋白胆固醇（TG/HDL-C）比值）、AP 和左心室功能障碍之间的相关性。这项回顾性研究纳入了 2018 年 8 月至 2021 年 12 月在河北医科大学第一医院因心肌梗死接受冠状动脉造影的 810 例患者。根据血清 AP 水平将患者分为三组。记录入院时的临床特征、心脏超声心动图检查结果、冠状动脉造影结果以及血清 AP 水平和甘油三酯（TG）等生化标志物。使用入院至冠状动脉造影期间进行的心脏超声心动图评估左心室射血分数（LVEF）。共有 774 例急性心肌梗死患者纳入本研究。TyG 指数与 TG/HDL-C 比值显著相关。（R = 0.739，P < 0.001）。二元逻辑回归分析显示，血清 AP 升高（OR 2.598，95%CI 1.331-5.071，P = 0.005）、左前降支（LAD）为梗死相关动脉（IRA）（OR 2.452，95%CI 1.352-4.449，P = 0.003）和甘油三酯（TG）水平（OR 0.652，95%CI 0.429-0.992，P = 0.046）是急性心肌梗死后入院时 LVEF<40%的保护性危险因素。血清碱性磷酸酶和 LAD 作为 IRA 是急性心肌梗死后住院期间 LVEF 严重降低的独立危险因素。相反，甘油三酯是急性心肌梗死后住院期间 LVEF 严重降低的独立保护因素。
