The Significance of Liver Transaminases (Aspartate Aminotransferase & Alanine Aminotransferase) In Newly Diagnosed Acute Myocardial Infarction

Introduction: Acute coronary events have been increasing and alterations of the myocardial function can be assessed  by evaluating the marker of liver cell injury. The ratio of AST to ALT is one of the most common indicators that is used in clinical practice and as a biomarker for cardiac events. We hypothesized that the AST/ALT ratio of the very first blood test at presentation can help evaluate the percentage of occlusion in patients with acute myocardial infarction in the absence of a coronary angiogram. This study aimed to study the correlation between AST and ALT changes in Acute Myocardial Infarction, compare AST/ALT ratio (De Ritis ratio) change versus Troponin I in patients with Acute Myocardial Infarction and comparison of De Ritis ratio in STEMI(ST segment elevation myocardial infarction)  and NSTEMI(Non-ST segment elevation myocardial infarction)Methods: Patients admitted to our hospital with related signs and symptoms (chest pain, pressure or tightness in the chest, sweating, nausea or vomiting etc) are later diagnosed for the first time to have Myocardial Infarction were considered.. Medical records and case sheets was referred whenever necessary to collect additional information.Results : Firstly, NSTEMI patients had significantly lower levels of ALT (Alanine Aminotransferase) compared to STEMI patients. Secondly the AST/ALT ratio, was significantly higher in STEMI patients (2.235) compared to NSTEMI patients (2.03).Lastly AST/ALT ratio is elevated among 75% of patients and Troponin I level is  elevated(positive) in all 100% of patients with MI.Conclusion: This study suggests that Troponin I levels is a better predictor of MI when compared with AST/ALT ratio.