Frequency and Prognostic Significance of Abnormal Liver
Function Tests in Patients With Cardiogenic Shock

J 2017

Frequency and Prognostic Significance of Abnormal Liver Function Tests in Patients With Cardiogenic Shock

JANTTI, T., T. TARVASMAKI, V.P. HARJOLA, J. PARISSIS, K. PULKKI et. al.

Základní údaje

Originální název

Frequency and Prognostic Significance of Abnormal Liver Function Tests in Patients With Cardiogenic Shock

Autoři

Vydání

American Journal of Cardiology, BRIDGEWATER, EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC, 2017, 0002-9149

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 3.171

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1016/j.amjcard.2017.06.049

UT WoS

000412626000008

Klíčová slova anglicky

Cardiogenic Shock

Štítky

EL OK

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 15. 3. 2018 15:59, Soňa Böhmová

Anotace

V originále

Cardiogenic shock (CS) is a cardiac emergency often leading to multiple organ failure and death. Assessing organ dysfunction and appropriate risk stratification are central for the optimal management of these patients. The purpose of this study was to assess the prevalence of abnormal liver function tests (LFTs), as well as early changes of LFTs and their impact on outcome in CS. We measured LFTs in 178 patients in CS from serial blood samples taken at 0 hours, 12 hours, and 24 hours. The associations of LFT abnormalities and their early changes with all-cause 90-day mortality were estimated using Fisher's exact test and Cox proportional hazards regression analysis. Baseline alanine aminotransferase (ALT) was abnormal in 58% of the patients, more frequently in nonsurvivors. Abnormalities in other LFTs analyzed (alkaline phosphatase, gamma-glutamyl transferase, and total bilirubin) were not associated with short-term mortality. An increase in ALT of >20% within 24 hours (AALT>+20%) was observed in 24% of patients. AALT>+20% was associated with a more than 2-fold increase in mortality compared with those with stable or decreasing ALT (70% and 28%, p <0.001). Multivariable regression analysis showed that AALT>+20% was associated with increased 90-day mortality independent of other known" risk factors. In conclusion, an increase in ALT in the initial phase was seen in 1/4 of patients in CS and was independently associated with 90-day mortality. This finding suggests that serial ALT measurements should be incorporated in the clinical assessment of patients in CS. (C) 2017 Elsevier Inc. All rights reserved.

Citovat

JANTTI, T., T. TARVASMAKI, V.P. HARJOLA, J. PARISSIS, K. PULKKI, A. SIONIS, J. SILVA-CARDOSO, L. KOBER, M. BANASZEWSKI, Jindřich ŠPINAR, V. FUHRMANN, J. TOLONEN, V. CARUBELLI, S. DISOMMA, A. MEBAZAA a J. LASSUS. Frequency and Prognostic Significance of Abnormal Liver Function Tests in Patients With Cardiogenic Shock. American Journal of Cardiology. BRIDGEWATER: EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC, 2017, roč. 120, č. 7, s. 1090-1097. ISSN 0002-9149. Dostupné z: https://dx.doi.org/10.1016/j.amjcard.2017.06.049.

@article{1398869,
   author = {Jantti, T. and Tarvasmaki, T. and Harjola, V.P. and Parissis, J. and Pulkki, K. and Sionis, A. and SilvaandCardoso, J. and Kober, L. and Banaszewski, M. and Špinar, Jindřich and Fuhrmann, V. and Tolonen, J. and Carubelli, V. and diSomma, S. and Mebazaa, A. and Lassus, J.},
   article_location = {BRIDGEWATER},
   article_number = {7},
   doi = {http://dx.doi.org/10.1016/j.amjcard.2017.06.049},
   keywords = {Cardiogenic Shock},
   language = {eng},
   issn = {0002-9149},
   journal = {American Journal of Cardiology},
   title = {Frequency and Prognostic Significance of Abnormal Liver Function Tests in Patients With Cardiogenic Shock},
   url = {http://dx.doi.org/10.1016/j.amjcard.2017.06.049},
   volume = {120},
   year = {2017}
}

TY  - JOUR
ID  - 1398869
AU  - Jantti, T. - Tarvasmaki, T. - Harjola, V.P. - Parissis, J. - Pulkki, K. - Sionis, A. - Silva-Cardoso, J. - Kober, L. - Banaszewski, M. - Špinar, Jindřich - Fuhrmann, V. - Tolonen, J. - Carubelli, V. - diSomma, S. - Mebazaa, A. - Lassus, J.
PY  - 2017
TI  - Frequency and Prognostic Significance of Abnormal Liver Function Tests in Patients With Cardiogenic Shock
JF  - American Journal of Cardiology
VL  - 120
IS  - 7
SP  - 1090-1097
EP  - 1090-1097
PB  - EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
SN  - 00029149
KW  - Cardiogenic Shock
UR  - http://dx.doi.org/10.1016/j.amjcard.2017.06.049
L2  - http://dx.doi.org/10.1016/j.amjcard.2017.06.049
N2  - Cardiogenic shock (CS) is a cardiac emergency often leading to multiple organ failure and death. Assessing organ dysfunction and appropriate risk stratification are central for the optimal management of these patients. The purpose of this study was to assess the prevalence of abnormal liver function tests (LFTs), as well as early changes of LFTs and their impact on outcome in CS. We measured LFTs in 178 patients in CS from serial blood samples taken at 0 hours, 12 hours, and 24 hours. The associations of LFT abnormalities and their early changes with all-cause 90-day mortality were estimated using Fisher's exact test and Cox proportional hazards regression analysis. Baseline alanine aminotransferase (ALT) was abnormal in 58% of the patients, more frequently in nonsurvivors. Abnormalities in other LFTs analyzed (alkaline phosphatase, gamma-glutamyl transferase, and total bilirubin) were not associated with short-term mortality. An increase in ALT of >20% within 24 hours (AALT>+20%) was observed in 24% of patients. AALT>+20% was associated with a more than 2-fold increase in mortality compared with those with stable or decreasing ALT (70% and 28%, p <0.001). Multivariable regression analysis showed that AALT>+20% was associated with increased 90-day mortality independent of other known" risk factors. In conclusion, an increase in ALT in the initial phase was seen in 1/4 of patients in CS and was independently associated with 90-day mortality. This finding suggests that serial ALT measurements should be incorporated in the clinical assessment of patients in CS. (C) 2017 Elsevier Inc. All rights reserved.
ER  -

JANTTI, T., T. TARVASMAKI, V.P. HARJOLA, J. PARISSIS, K. PULKKI, A. SIONIS, J. SILVA-CARDOSO, L. KOBER, M. BANASZEWSKI, Jindřich ŠPINAR, V. FUHRMANN, J. TOLONEN, V. CARUBELLI, S. DISOMMA, A. MEBAZAA a J. LASSUS. Frequency and Prognostic Significance of Abnormal Liver Function Tests in Patients With Cardiogenic Shock. \textit{American Journal of Cardiology}. BRIDGEWATER: EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC, 2017, roč.~120, č.~7, s.~1090-1097. ISSN~0002-9149. Dostupné z: https://dx.doi.org/10.1016/j.amjcard.2017.06.049.

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