Association Between Serum Alkaline Phosphatase And Severity Of Coronary Artery Disease And Prognosis Of Patients With Coronary Heart Disease

Objective: To analysis the association between serum alkaline phosphatase and severity of coronary artery disease and prognosis of patients with coronary heart disease.Methods: We consecutively enrolled 388 hospitalized patients who were first diagnosed with coronary heart disease by coronary angiography in the First Affiliated Hospital of Jinan University during the period from January 2016 to December 2016.Patients were divided into high ALP group(≥ 82.8mmol/L)(n=194)and low ALP group(< 82.8mmol/L)(n=194)according to the median of serum ALP level(82.8mmol/L).Gensini scores were compared between the two groups.The patients was divided into low Gensini subgroup(< 32 points)and high Gensini subgroup(≥32 points)according to the median of Gensini score.The relationship between serum ALP and Gensini score was determined by Logistic regression.The ROC curve was used to study the predictive effect of ALP on the Gensini score of patients with coronary heart disease.Cox proportional risk regression was used to analyze risk factors affecting outcome events in patients with coronary heart disease.The ROC curve was used to study the predictive effect of serum ALP level on long-term prognosis of patients with coronary heart disease.And we identified the optimal serum ALP level cut-off value for predicting occurrence of the composite endpoint.The correlation between left ventricular ejection fraction and ALP was also analyzed.Results: The Gensini score of patients in the high ALP group was higher than that in the low ALP group(48.9±38.3 vs 36.1±30.2,P<0.001).Elevated serum ALP level was an independent risk factor for increased Gensini score(OR:1.022,95%CI:1.007-1.037,P=0.003).The area under the ROC curve was 0.620(P<0.001).Elevated ALP is an independent risk factor for the occurrence of major adverse cardiac and cerebrovascular event(HR : 1.010,95%CI :1.005-1.015,P<0.001).The optimal ALP value was 82.2U/L with a maximum area under the curve of 0.687(sensitivity 71.2% and specificity 63.7%,P<0.001).There was a negative correlation between serum alkaline phosphatase and left ventricular ejection fraction(r=-0.126,P=0.013).Conclusion: 1.Serum ALP is positively correlated with the severity of coronary artery disease.The elevated level of serum ALP is an independent risk factor for advanced coronary artery disease.2.The elevated level of serum ALP is an independent risk factor for major adverse cardiac and cerebrovascular event in patients with coronary heart disease during the follow-up of2 years.3.There is a negative correlation between serum ALP level and left ventricular ejection fraction.Left ventricular ejection fraction decreased with the increase of serum ALP.