Study on prediction of biomarkers for acute liver injury after acute myocardial infarction after AMI

ZHANG Tian-xing; FENG Shu-hui; HAN Xue-xue; ZHOU Xing-zhu; XIA Jing-gang

doi:10.3969/j.issn.1672-5301.2025.03.002

Abstract：Objective To explore the biomarkers associated with acute liver injury(ALI)after acute myocardial infarction(AMI).Methods The demographic characteristics,past medical history and auxiliary examination indexes of AMI patients admitted to the Department of Cardiology,Xuanwu Hospital,Capital Medical University from January 2017 to December 2022 were analyzed.The clinical indicators of AMI patients admitted to the same Department from September 2022 to April 2023 were analyzed;and Olink proteomics technology was used to explore the plasma proteins associated with ALI after AMI.Results A total of 3006 patients were included in the retrospective study,including 325 patients in the ALI group and 2681 patients in the non-ALI group.Patients in the ALI group were older and had worse cardiac function,higher GRACE score,white blood cell count,neutrophil count,fasting blood glucose,creatinine,uric acid,peak troponin I(TnI),high-sensitivity C-reactive protein(hs-CRP),Interleukin-6(IL-6)and left ventricular end-diastolic diameter(LVEDD)levels on admission,and higher incidence of major adverse cardiovascular and cerebrovascular events(MACCE)in hospital(P<0.05).Regression analysis showed that GRACE risk score(OR=1.010,95%CI 1.004-1.016),uric acid(OR=1.002,95%CI 1.001-1.003)and TnI peak(OR=1.027,95%CI 1.019-1.035)were the independent risk factors for in-hospital ALI in AMI patients.A total of 86 patients were included in the prospective study,including 13 patients in the ALI group and 73 patients in the non-ALI group.The ALI group had poor cardiac function,higher peak value of white blood cell count,neutrophil count,fasting blood glucose and TnI,and higher incidence of MACCE in hospital(P<0.05).Proteomic analysis showed that 29 proteins were significantly increased in the plasma of the ALI group(P<0.05).Among them,von Willebrand factor(vWF)and plasminogen activator inhibitor(PAI)had higher area values under the subject operating characteristic curve,which had good predictive value for the occurrence of ALI after AMI.Conclusion The uric acid,vWF and PAI are closely related to the development of ALI after AMI,suggesting that inflammatory response,oxidative stress and apoptosis may play an important role in ALI,and may become new intervention targets to improve prognosis.