Abstract 12482: Serum Alkaline Phosphatase is a Predictor of Mortality, Myocardial Infarction, or Stent Thrombosis after Implantation of Coronary Drug-Eluting Stent

Abstract

Background The association between ALP and mortality was reported in several subgroups of patients. But, the role of ALP in overall CAD patients after PCI remains unknown. The aim of this study was to examine the prognostic value of alkaline phosphatase (ALP) level in patients with coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI) with drug-eluting stent (DES).

Methods and Results We prospectively included CAD patients who underwent PCI with DES. After exclusion of patients with liver disease and cancer, 1,636 patients were selected for the analysis, and were classified into tertiles by baseline measurements of ALP (<63, 63-78, and >78 IU/L). After adjustment of potential confounders including angiographic data, the independent and dose-dependent association was observed between tertile of ALP and the adjusted hazard ratio (HR) of all-cause mortality (p for trend<0.0001). Specifically, compared to the lowest ALP tertile, the adjusted HR of all-cause mortality in the highest tertile was 3.35 (95% confidence interval 1.61-6.94). In subgroup of patients with stable or unstable angina, a similar association was noted (p for trend<0.0001). In terms of cardiovascular mortality, myocardial infarction, and stent thrombosis, the adjusted HRs in the highest ALP tertile were 3.40 (1.19-9.75), 3.72 (1.03-13.42), and 2.64 (1.29-5.44), respectively, compared with the lowest tertile. Furthermore, evaluation of both ALP and C-reactive protein provided better predictive value than either alone.

Conclusions Our study demonstrated that the higher serum ALP level is an independent predictor of mortality, myocardial infarction, and stent thrombosis in CAD patients after PCI with DES.