Abstract 12037: Alanine Aminotransferase Levels and Incident Cardiovascular Events
Introduction: The relationship between hepatic serum markers within the normal range and cardiovascular risk is uncertain.
Hypothesis: Alanine aminotransferase (ALT) levels in normal range predicts cardiovascular risk.
Methods: 17,515 men and women free of cardiovascular disease participating in a randomized placebo controlled trial of rosuvastatin 20 mg daily had baseline levels of ALT below the lower limits of normal (<40 IU/L) and were followed prospectively for first ever cardiovascular events. Cox proportional hazards models were used to calculate the relative risks of these events according to increasing tertiles and each standard deviation increase in baseline ALT levels.
Results: ALT levels at study entry, all within the normal range, were inversely associated with age, smoking status, and inflammation and were positively associated with male gender, alcohol use, and triglycerides. Incident cardiovascular event rates were highest among those in the lowest tertile of baseline ALT; specifically, incidence rates were 1.43, 0.98, and 0.85 per 100 person years of exposure for those in the lowest, middle, and highest tertile of baseline ALT within the normal range, respectively (P< 0.001). These inverse effects remained statistically significant after multivariable adjustment for a wide range of vascular risk factors risk markers such that each higher standard deviation unit of ALT was associated with an 18 percent lower event rate (RR 0.82, 95%CI 0.72-0.93,P=0.002). The efficacy of statin therapy was not modified by baseline ALT level.
Conclusions: Increasing alanine aminotransferase levels within the normal range are inversely associated with future cardiovascular risk.
Author Disclosures: P.H. Harada: None. D.E. Cohen: None. L. Rose: None. P.M. Ridker: Research Grant; Significant; AstraZeneca.
- © 2014 by American Heart Association, Inc.