Correlation Analysis Between Alanine Aminotransferase And The Degree Of Coronary Atherosclerosis Lesion In Patients With Acute ST Segment Elevation Myocardial Infarction

Objective:To investigate the correlation between serum alanine aminotransferase(ALT)level and the degree of coronary atherosclerosis lesion in patients with acute ST segment elevation myocardial infarction(STEMI).Methods:A total of 389 patients with acute STEMI diagnosed for the first time in the second Hospital of Shanxi Medical University from August 2018 to August 2020 were selected,including 306 males(78.7%)and 83 females(21.3%),all patients underwent emergency coronary angiography(CAG)examination and calculate the coronary Gensini score.The medical records of all selected patients were collected,including baseline data such as age and gender,laboratory data such as blood routine,blood lipids,liver and kidney function,as well as the results of cardiac color ultrasound and coronary angiography,the subjects were divided into normal ALT group(212cases)and high ALT group(177cases)according to the reference range of ALT,according to the median Gensini score,the subjects were divided into low Gensini group(205cases)and high Gensini group(184cases),the correlation between serum ALT level and coronary Gensini score in patients with STEMI was analyzed.Results:Compared of the baseline data between the normal ALT group and the high ALT group,there were no significant difference in gender,age and other data between the two groups(P>0.05),the difference of the number of single vessel and triple vessel coronary artery lesion were statistically significant(P<0.05);The laboratory data between the two groups were compared,there were no significant difference in HGB,PLT,TG,HDL,TP,Cr,LVEDD(P>0.05),WBC,AST,ALP,GGT,GLU,AST/ALT,TBIL,DBIL,IBIL,LDH,TC,LDL,ALB,BUN,LVEF,Gensini score difference was statistically significant(P<0.05).Compared of the baseline data between the low Gensini score group and the high Gensini score group,there were no significant difference in gender,age and other data between the two groups(P>0.05),the difference of the number of triple vessel coronary artery lesion were statistically significant(P<0.05);The laboratory data between the two groups were compared,there were no significant difference in HGB,ALP,TG,HDL,TP,ALB,Cr,LVEF and LVEDD between the two groups(P>0.05),WBC,PLT,ALT,AST,GGT,GLU,AST/ALT,TBIL,DBIL,IBIL,LDH,TC,LDL and BUN difference were statistically significant(P<0.05).Spearman correlation analysis was performed between serum ALT and AST values of STEMI patients and Gensini score,the results showed that serum ALT and AST values were positively correlated with Gensini score,and the correlation coefficients were respectively(r=0.828,P<0.05)and(r= 0.870,P<0.05).Binary logistic regression analysis showed that the main factors affecting the degree of coronary artery stenosis in STEMI patients were ALT(OR=1.069,95%CI:1.017～1.124,P=0.009)and AST(OR=1.049,95%CI: 1.026 ～ 1.072,P = 0.000),with the increase of serum ALT and AST levels,the higher the risk of high Gensini score in STEMI patients,the more serious the degree of coronary artery stenosis.Conclusion:The serum ALT level was correlated with the degree of coronary lesion in STEMI patients,high serum ALT level was an independent risk factor for high Gensini score in STEMI patients,and ALT could predict the severity degree of coronary lesion in STEMI patients.