Atherosclerosis and Liver Function Tests in Coronary Angiography Patients

Abstract

Objective: Elevated aminotransferase levels indicating liver function,even in the normal range, have attracted great concern as potentialnovel markers of cardiovascular risk assessment. We hypothesized thepossibility that liver function test variations in the normal rangemight be meaningfully associated to coronary artery disease (CAD).Method: Eighty-eight patients were randomly selected from those whounderwent coronary angiography from June 2010 to June 2011 afterapplying to the outpatient cardiology clinic in Gulhane Military MedicalAcademy. According to the results of angiographies, patients wereclassified into three groups as normal, non-critical (< 50% involvementin coronaries), and critical (>= 50% involvement in coronaries). Inaddition to angiographic intervention, measurements of serum aspartateaminotransferase (AST) and alanine aminotransferase (ALT)concentrations, albumin and the other serum parameters were performed inall patients.Results: The patient groups of CAD were balanced (28 critical cases, 30non-critical cases and 30 normal cases). Mean age was 51.93 +/- 9.3(range 32-65) years and 19.3 per cent (n = 17) were females. Multiplelinear regression analysis of all three liver function tests explained asignificant portion of the variance, but adjusted r-squares were small(AST = 0.174, ALT = 0.242, albumin = 0.124). Albumin was significantlyhigher for patients with critical CAD than for patients with no CAD(beta = 3.205, p = 0.002). Non-critical CAD was not significantlydifferent from no CAD for any of the dependent variables. Mean AST wassignificantly higher for patients taking aspirin (beta = 0.218, p =0.049), as was mean ALT (beta = 0.264, p = 0.015).Conclusion: Alanine aminotransferase and AST may not be associated withangiographically determined coronary atherosclerosis. Albumin may bemore sensitive to demonstrate the burden of atherosclerosis. Theseresults indicate that the association between the liver function testsand coronary atherosclerosis may be more complex than generallyappreciated.