The value of aspartate aminotransferase and alanine aminotransferase in cardiovascular disease risk assessment

Open Heart
Stephen F WengNadeem Qureshi

Abstract

Aspartate aminotransferase to alanine aminotransferase (AST/ALT) ratio, reflecting liver disease severity, has been associated with increased risk of cardiovascular disease (CVD). The aim of this study was to evaluate whether the AST/ALT ratio improves established risk prediction tools in a primary care population. Data were analysed from a prospective cohort of 29 316 UK primary care patients, aged 25-84 years with no history of CVD at baseline. Cox proportional hazards regression was used to derive 10-year multivariate risk models for the first occurrence of CVD based on two established risk prediction tools (Framingham and QRISK2), with and without including the AST/ALT ratio. Overall, model performance was assessed by discriminatory accuracy (AUC c-statistic). During a total follow-up of 120 462 person-years, 782 patients (59% men) experienced their first CVD event. Multivariate models showed that elevated AST/ALT ratios were significantly associated with CVD in men (Framingham: HR 1.37, 95% CI 1.05 to 1.79; QRISK2: HR 1.40, 95% CI 1.04 to 1.89) but not in women (Framingham: HR 1.06, 95% CI 0.78 to 1.43; QRISK2: HR 0.97, 95% CI 0.70 to 1.35). Including the AST/ALT ratio with all Framingham risk factors (AUC c-statistic: 0.7...Continue Reading

Citations

Jan 14, 2021·The Aging Male : the Official Journal of the International Society for the Study of the Aging Male·Aksam A YassinFarid Saad
Nov 21, 2020·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·Maurizio VialeMattia Rocco
Nov 19, 2020·Disease Markers·Zhengri LuLijuan Chen
Apr 11, 2020·Annals of Medicine and Surgery·Ginenus FekaduAyantu Kebede
May 22, 2021·Frontiers in Immunology·Ricarda Cortés-VieyraVíctor M Baizabal-Aguirre
Aug 5, 2021·Metabolic Syndrome and Related Disorders·Akinkunle Oye-SomefunChris I Ardern

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QRISK2

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