ABS-9 : Putu Satyakumara Upadhana, I Gede Gita Sastrawan, I Gusti Agung Ayu Chintya Cahyarini, John Nolan, I Ketut Agus Somia – The Association Of Transaminitis with Preexisting Comorbidities and Role AST/ALT Ratio On
Outcome Of All Types Of Cardiovascular Emergency Patients Admitted to Intensive
Cardiovascular Care Unit In Sanglah Hospital Bali, Indonesia: The Interrelationship for a Severe
Course

The Association Of Transaminitis with Preexisting Comorbidities and Role AST/ALT Ratio On Outcome Of All Types Of Cardiovascular Emergency Patients Admitted to Intensive Cardiovascular Care Unit In Sanglah Hospital Bali, Indonesia: The Interrelationship for a Severe Course

Putu Satyakumara Upadhana¹, I Gede Gita Sastrawan¹, I Gusti Agung Ayu Chintya Cahyarini¹, John Nolan¹, I Ketut Agus Somia²

¹Bachelor of Medicine and Medical Profession Study, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia; ²Department of Internal Medicine, Sanglah General Hospital Denpasar, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

Background: Transaminitis seems to be linked with worse outcomes and increased risk of death in patients with cardiovascular emergency. This study aims to determine the impact of transaminitis and role of AST/ALT ratio on outcome of patients with cardiovascular emergency.

Methods: This research is an analytic study with a cross-sectional approach. The data used is secondary data from the records of patients who were admitted to intensive cardiovascular care unit at Sanglah Hospital on 1 January 2021- 31 December 2021 using the total sampling technique.

Results: There were 511 patients included in this study. The majority of patients were male (n=362, 70.8%) with the median overall patient age of 58 years old. Most of the cardiovascular emergency and comorbidities found in the patients were acute coronary syndrome (n=464; 90.8%) and kidney disease (n=232;45.4%). A total of 105 patients had transaminitis (20.5%). There were significant differences in hemoglobin (p=0.048), white blood cells (p=0.000), neutrophils count (p=0.000), monocytes count (p=0.000), and neutrophils to lymphocytes ratio (p=0.031) in the patients classified based on transaminitis comorbidity. Chi-square analysis showed that male (PR=1.467; 95%CI=1.963-2.236;p=0.047), mortality (PR=1.788 ;95%CI=1.252-2-553;p=0.002) , cardiogenic shock (PR=1.559;95%CI=1.031-2.359;p=0.043), malignant arrhytmia (PR=1.439;95%CI=1.012-2.046;p=0.046), type 2 diabetes mellitus (PR=1.369;95%CI=1.062-1.949;p=0.045), sepsis (PR=1.864;95%CI=1.163-2.988;p=0.017), COVID-19 (PR=1.999;95%CI=1.429-2.797) and kidney disease (PR=1.542;95%CI=1.094-2.176;p=0.013) were significantly associated with transaminitis. Logistic regression analysis showed that there was a significant association of male (PR=1.930;95%CI=1.101-3.384;p=0.022), mortality (PR=2.085;95%CI=1.946-4.596;p=0.048), dyslipidemia (PR=1.886;95%CI=1.060-3.354;p=0.031) with transaminitis. ROC curved showed the optimal cut-off of AST/ALT ratio for the in-hospital death prediction was >1.61% (p=0.000) with sensitivity of 70.1% and specificity of 59.9%. AST/ALT ratio also found to be higher (p=0.000) in patients with in-hospital death event.

Conclusions: There were significant association between pre-existing comorbidities and laboratory parameter with transaminitis in the patients. Early intervention on these factors can prevent further mortality.

Keywords: Cardiovascular emergencies, Transaminitis, AST/ALT ratio, Comorbidities, Intensive care unit