Document Detail


Perioperative serum aspartate aminotransferase level as a predictor of survival after coronary artery bypass grafting.
MedLine Citation:
PMID:  22841017     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Elevated cardiac enzymes after coronary artery bypass grafting (CABG) surgery have been identified as a risk factor for worse postoperative outcome. Cardiac enzymes play an important role in the diagnosis of perioperative myocardial infarction. This study aims to investigate the predictive value of aspartate aminotransferase (AST) with respect to early and late mortality after CABG.
METHODS: Patients undergoing isolated CABG in a single center between January 1998 and December 2010 were prospectively enrolled in our database. Patients were arbitrarily divided into 4 groups according to the postoperative AST level: group 1 (AST < 50 U/L), group 2 (AST = 51 to 100 U/L), group 3 (AST = 101 to 200 U/L), group 4 (AST = 201 to 300 U/L), and group 5 (AST > 300 U/L). The impact of biomedical variables on early mortality was determined using univariate and multivariate logistic regression analyses. Risk factors for late mortality were identified using Cox proportional hazard regression analyses.
RESULTS: The study population consisted of 13,505 patients who underwent isolated CABG. Postoperative AST level was identified as a risk factor for early (odds ratio = 3.6 [2.5 to 5.4], p < 0.0001) and late mortality (hazard ratio = 1.4 [1.2 to 1.7], p < 0.001). After correction for other risk factors, AST level was an independent predictor of worse survival.
CONCLUSIONS: Elevated postoperative AST level is an independent predictor of early and late mortality after CABG. Although it is not a specific indicator for cardiac damage, it can reflect ischemic effects on the other organs as an indirect sign of depressed cardiac function.
Authors:
Astrid G M van Boxtel; Sander Bramer; Mohamed A Soliman Hamad; Albert H M van Straten
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Publication Detail:
Type:  Journal Article     Date:  2012-07-26
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  94     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-26     Completed Date:  2013-01-07     Revised Date:  2013-09-24    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1492-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aspartate Aminotransferases / blood*
Coronary Artery Bypass / mortality*
Female
Humans
Male
Middle Aged
Postoperative Care
Predictive Value of Tests
Prospective Studies
Survival Rate
Time Factors
Chemical
Reg. No./Substance:
EC 2.6.1.1/Aspartate Aminotransferases
Comments/Corrections
Comment In:
Ann Thorac Surg. 2012 Nov;94(5):1498-9   [PMID:  23098932 ]
Ann Thorac Surg. 2013 Aug;96(2):740   [PMID:  23910130 ]
Ann Thorac Surg. 2013 Aug;96(2):740   [PMID:  23910131 ]

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