Value of Alkaline Phosphatase in Predicting the Extent and Severity of Coronary Artery Disease in Acute Myocardial Infarction

Abstract

Introduction: The serum alkaline phosphatase (ALP) level has been shown to be a prognostic factor in stable coronary artery disease (CAD) and acute myocardial infarction (AMI) by its promoting effect on vascular calcification. The objectives of this study were to investigate serum ALP levels and to determine their value in predicting the extent and severity of CAD in patients with AMI.

Patients and Methods: A total of 200 patients with AMI were included in this study. Patients with serum ALP levels higher than 120 mg/dL were classified as elevated ALP group. The extent and severity of CAD was assessed using Gensini score and number of vessel disease. Patients with a Gensini score greater than 40 were included in advanced CAD group.

Results: There was no relationship between the ALP level and the Gensini score in study population. Patients were grouped according to the Gensini score (Gensini scores ≤ 40 and > 40). There was no difference between the groups in terms of ALP levels. However, ALP levels were significantly higher in diabetic patients and in patients with non—ST-segment elevation myocardial infarction (NSTEMI). Parathormone levels and neutrophil counts were significantly higher in the advanced CAD group.

Conclusion: ALP levels do not indicate the extent and severity of CAD in patients with AMI. However, these levels are higher in diabetic patients and in patients with NSTEMI than in patients with ST-segment elevation myocardial infarction. Higher parathormone levels and neutrophil counts are related to the extent and severity of CAD in patients with AMI.

Keywords

• Alkaline phosphatase,coronary angiography,myocardial infarction,coronary artery disease,parathyroid hormone

Akut Miyokart İnfarktüsünde Koroner Arter Hastalığının Yaygınlığını ve Ciddiyetini Tahmin Etmede Alkalen Fosfatazın Değeri

Abstract

Giriş: Serum alkalen fosfataz (ALP) seviyesi, vasküler kalsifikasyon üzerine olan tetikleyici etkisinden dolayı akut miyokart infarktüsü (AMİ)’nde ve stabil koroner arter hastalığı (KAH)’nda prognostik bir faktör olarak gösterilmiştir. Çalışmanın amacı, AMİ hastalarında serum ALP seviyelerini araştırmak ve KAH’ın yaygınlığı ve ciddiyetini tahmin etmedeki değerini saptamaktır.

Hastalar ve Yöntem: Bu çalışmaya AMİ geçiren toplam 200 hasta dahil edildi. Serum ALP düzeyleri 120 mg/dL’den yüksek olanlar, yükselmiş ALP grubu olarak tanımlandı. KAH’ın yaygınlığı ve ciddiyeti, Gensini skoru ve hasta damar sayısı ile değerlendirildi. Gensini skoru 40’ın üzerinde olan hastalar, ilerlemiş KAH grubuna dahil edildi.

Bulgular: Çalışma popülasyonunda ALP düzeyi ve Gensini skoru arasında ilişki yoktu. Hastalar Gensini skorlarına göre gruplandırıldı (Gensini skoru ≤ 40 ve Gensini skoru > 40). Gruplar arasında ALP düzeyi açısından fark yoktu. Bununla birlikte, ALP düzeyleri diyabetik hastalarda ve  ST elevasyonsuz miyokart infarktüsü (NSTEMİ) olan hastalarda anlamlı derecede daha yüksekti. Parathormon düzeyleri ve nötrofil sayıları, ilerlemiş KAH grubunda anlamlı olarak yüksek bulundu.

Sonuç: ALP düzeyi, AMİ’li hastalarda KAH yaygınlığı ve ciddiyetini göstermemektedir. Bununla birlikte ALP düzeyleri, diyabetik hastalarda ve ST elevasyonlu miyokart infarktüsü (STEMİ) hastalarıyla kıyaslandığında NSTEMİ hastalarında daha yüksektir. Yüksek parathormon düzeyi ve nötrofil sayısı, AMİ’de KAH yaygınlığı ve ciddiyeti ile ilişkilidir.

Keywords

• Alkalen fosfataz,koroner anjiyografi,miyokart infarktüsü,koroner arter hastalığı,paratiroid hormon

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