Relationship between serum alanine aminotransferase and the severity and prognosis of coronary lesions in elderly patients with coronary heart disease

Objective To investigate the relationship between serum ALT levels and the severity and prognosis of coronary lesions, in order to provide important predictive value for early diagnosis and prognosis of patients with coronary heart disease. Methods A total of 240 patients with coronary heart disease were selected. After coronary angiography, the patients were divided into three groups according to the SYNTAX score, they were low-risk group(SYNTAX score was 0-22), middle-risk group(SYNTAX score was 23-32) and high-risk group(SYNTAX score was higher than 33 points). Sixty cases with coronary angiography results of no clear stenotic lesions or the lesions <50% were selected as the control group. The clinical data, biochemical data and coronary artery angiography were recorded. All patients with coronary artery disease were followed up for a period of one year after discharge and the occurrence of major adverse cardiac events (MACE) was recorded. Results ①The differences in sex composition, ALT, AST, TBiL, DBiL, TC, TG, HDL-C, LDL-C, GLU between the control group and each subgroup of coronary lesions were significant (all P 0.05). With the increase of severity of coronary artery lesions, ALT level gradually increased, the ALT level in each subgroup of patients with coronary artery disease were (50.00±24.00) U/L, (63.0±36.50) U/L, and (64.00±41.50) U/L, which were significantly higher than those of the control group, the differences were significant (P 0.05). ②Spearman analysis showed that serum ALT level was positively correlated with GLU, TC, TG, LDL-C (P<0.05) and negatively correlated with HDL-C(P<0.05). The serum ACT levels in the cornary lesions groups were positively correlated with the SYNTAX scores (r=0.305, P=0.000) ③Logistic regression analysis showed that sex, ALT, IBIL, TC, LDL-C and GLU were the independent risk factors for the severity of coronary lesions. ④ROC curve results showed that the area of ALT was 0.664, which was lower than TC (0.715), LDL-C (0.702), and AST (0.667), but higher than UA (0.627), GLU (0.612), IBIL (0.409), and gender (0.405). TBIL (0.390). ⑤From the Kaplan-Meier curve, it can be seen that the incidence of MACE is significantly higher in patients with high levels of ALT than that in patients with low levels of ALT (P=0.018). Conclusions The level of serum alanine aminotransferase can reflect the severity of coronary artery disease in patients with coronary heart disease, which is a risk factor for the severity of coronary artery disease and has an important predictive value for the poor prognosis of coronary heart disease. Key words: Coronary heart disease; Alanine aminotransferase; SYNTAX score; Prognosis