De Ritis ratio (AST/ALT) as an independent predictor of poor outcome in patients with acute ischemic stroke

Gao, Fan; Chen, Chen; Lu, Jun; Zheng, Jie; Ma, Xiancang; Yuan, Xingyun; Huo, Kang; Han, Jianfeng

doi:10.2147/ndt.s139316

Cited by 36 publications

(29 citation statements)

References 30 publications

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“…erefore, AAR can be used for the diagnosis and prognosis of various diseases. In addition, the predictive utility of AAR was reported for acute ischemic stroke [41], cardiovascular events, [21] and peripheral arterial occlusive disease [42], where a group with AAR >1.67 had more frequent myocardial infarction, atrial fibrillation, and heart failure.…”

Section: Discussionmentioning

confidence: 99%

Association between Alanine Aminotransferase/Aspartate Aminotransferase Ratio (AST/ALT Ratio) and Coronary Artery Injury in Children with Kawasaki Disease

Ren

Shi

et al. 2020

Cardiology Research and Practice

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Objective. To investigate the association between the aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio (AST/ALT ratio, AAR) and intravenous immunoglobulin (IVIG) resistance, coronary artery lesions (CAL), and coronary artery aneurysms (CAA) in children with Kawasaki disease (KD). Design. We retrospectively studied 2678 children with KD and divided them into two groups: a low-AAR group and a high-AAR group with a median AAR of 1.13 as the cut-off point. The differences in laboratory data, clinical manifestations, and coronary artery damage rates were compared between the two groups. Results. The incidence of CAL was higher in the low-AAR group than in the high-AAR group at 2 and 3-4 weeks after illness onset (p<0.001, respectively). The IVIG resistance rate was significantly higher in the low-AAR group than in the high-AAR group (29.94% vs 21.71%, p<0.001). The levels of C-reactive protein, erythrocyte sedimentation rate, white blood cell count, bilirubin, fibrinogen, thrombin time, D-dimer, and brain natriuretic peptide were also significantly higher in the low-AAR group compared with the high-AAR group. The levels of albumin and IgG were significantly lower in the low-AAR group compared with those of the high-AAR group. The proportion of typical KD cases in the low-AAR group was significantly higher than that in the high-AAR group. Low-AAR correlated with the risk of coronary artery damage and IVIG resistance. Conclusion. Children with KD who had low-AAR value were more likely to develop coronary artery damage and IVIG resistance. Low AAR is a risk factor for CAL, CAA, and IVIG resistance in KD.

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Section: Discussionmentioning

confidence: 99%

Association between Alanine Aminotransferase/Aspartate Aminotransferase Ratio (AST/ALT Ratio) and Coronary Artery Injury in Children with Kawasaki Disease

Ren

Shi

et al. 2020

Cardiology Research and Practice

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“…Since then, the value of AST/ALT in cardiovascular and cerebrovascular diseases has gradually attracted the consideration of researchers [ 13 , 14 ]. Several studies demonstrated that elevated AST/ALT, assessed at baseline, is an independent risk factor for morbidity and mortality in cardiovascular disease [ 6 , 15 , 16 ]. Since baPWV is also associated with cardiovascular morbidity and mortality, the potential clinical value of this study is that AST/ALT may be used for the assessment of arterial stiffness in the future.…”

Section: Discussionmentioning

confidence: 99%

AST to ALT ratio and arterial stiffness in non-fatty liver Japanese population:a secondary analysis based on a cross-sectional study

et al. 2018

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BackgroundPrevious studies have revealed that triglyceride to high-density lipoprotein cholesterol (HDL-C) ratio (henceforth TG/HDL-C) is one of the major risk factors for cardiovascular disease, insulin resistance and metabolism syndrome. However, there are fewer investigations of the correlations between the aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio and brachial ankle pulse wave velocity (baPWV). This study was undertaken to investigate the relationship between the AST to ALT ratio and brachial-ankle pulse wave velocity (baPWV) in a Japanese population.MethodsThe present study was a cross-sectional study. A total of 646 Japanese men and women without fatty liver, aged 24—84 years old, received a health medical check-up programme including the results from baPWV inspection and various standardized questionnaires in a health examination centre in Japan. Main outcome measures included AST/ALT ratio, baPWV, fatty liver and postmenopausal status. Abdominal ultrasonography was used to diagnose fatty liver. A postmenopausal state was defined as beginning 1 year following the cessation of menses.ResultsAfter adjusting for potential confounders (age, sex, BMI, SBP, DBP, AST, ALT, GGT, uric acid, fasting glucose, TC, LDL, eGFR, smoking and exercise statuses, fatty liver, alcohol consumption and ABI), a non-linear relationship was detected between AST/ALT and baPWV, which had an inflection point of 5.6. The effect sizes and the confidence intervals on the left and right sides of the inflection point were 12.7 (1.9 to 23.5) and − 16.7 (− 36.8 to 3.3), respectively. Subgroup analysis in participants with excessive alcohol consumption (more than 280 g/week) showed that AST/ALT had a negative correlation with baPWV (β = − 30.7, 95%CI (− 53.1, − 8.4)), and the P value for the interaction was less than 0.05.ConclusionThe relationship between AST/ALT and baPWV is non-linear. AST/ALT was positively correlated with baPWV when AST/ALT was less than 5.6. In addition, the trend was the opposite in subjects who consumed excessive amounts of alcohol.

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“…Not only in malignant tumors, the predictive value of DRR in other diseases is also noteworthy. For example, DRR was the independent risk factors of acute ischemic stroke (AIS) and peripheral arterial occlusive disease, as reported by Gao, F. and Rief, P. respectively [22,23] . Rahmani J et al found that high levels of gamma-glutamyl transpeptidase, A Lkaline Phosphatase, AST/ALT were all associated with an increased mortality rate of patients with cardiovascular disease through systematic review and meta-analysis including more than 1 million participants [31] .…”

Section: Relation To Previous Workmentioning

confidence: 63%

“…The distribution of AST is noted in different tissues and organs, which presents with extensive elevation under expose to not only liver damage but other conditions with great need in high metabolic activity, especially for tumor progression [20,21] . In addition to malignant tumors, previous studies also indicated that these biomarkers were also associated with the development and progression of acute ischemic stroke, renal dysfunction, respiratory dysfunction, peripheral arterial occlusive disease [22][23][24][25] . As these diseases are accompanied by abnormalities in cell metabolism, an increase in anaerobic glycolysis tends to cause a disproportionate increase in AST and ALT [26] .…”

Section: Introductionmentioning

confidence: 99%

Aspartate transaminase/alanine transaminase ratio as a significant prognostic factor in patients with sepsis: a retrospective analysis

Zhao

Yao

Ren

et al. 2020

Preprint

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Background: The study was performed to investigate the relationship between aspartate transaminase/alanine transaminase ratio (DRR) and long-term mortality among patients diagnosed with sepsis or septic shock. Methods: We conducted a retrospective study among adult septic patients who were admitted to surgical intensive care unit (ICU) of the Chinese People's Liberation Army (PLA) General Hospital from January 2014 to December 2018. Baseline characteristics were compared between survivors and non-survivors. We applied univariate as well as multivariate Cox regression analyses to evaluate DRR in relation to 180-day mortality. The potential prognostic value of DRR in predicting mortality rate was assessed by receiver operating curve (ROC) analysis. Besides, we conducted subgroup analysis by stratifying patients via optimal DRR cut-off value. Results: We included a total number of 183 patients in the current study, 44 (24%) patients died within 180-day hospitalization. Univariate and multivariate Cox analysis revealed that DRR was an independent predictor of 180-day mortality (hazard ratio [HR] 1.421, 95% confidence interval [CI] 1.073-1.883, P = 0.014). The predicting accuracy of 180-day mortality for DRR was presented as ROC with an area under the curve (AUC) of 0.708 (95% CI 0.629–0.786, P < 0.001). As we stratified all enrolled patients into two groups by using the optimal cut-off value of 1.29, we observed a significantly higher mortality in patients with relatively high DRR. Conclusions: An elevated DRR was associated with higher 180-day mortality among septic patients, and DRR might be an optimal marker for predicting the long-term mortality of sepsis. More prospective and randomized trials are needed to confirm the prognostic value of DRR.

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De Ritis ratio (AST/ALT) as an independent predictor of poor outcome in patients with acute ischemic stroke

Cited by 36 publications

References 30 publications

Association between Alanine Aminotransferase/Aspartate Aminotransferase Ratio (AST/ALT Ratio) and Coronary Artery Injury in Children with Kawasaki Disease

Association between Alanine Aminotransferase/Aspartate Aminotransferase Ratio (AST/ALT Ratio) and Coronary Artery Injury in Children with Kawasaki Disease

AST to ALT ratio and arterial stiffness in non-fatty liver Japanese population:a secondary analysis based on a cross-sectional study

Aspartate transaminase/alanine transaminase ratio as a significant prognostic factor in patients with sepsis: a retrospective analysis

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