Background Serum lactate dehydrogenase (LDH) and total bilirubin (TB) have been shown to increase during acute myocardial infarction (AMI). However, how they associate with the prognosis of these patients is still unknown.
Methods A total of 239 patients with AMI, who were admitted to the fourth clinical hospital of Harbin Medical University between 2007 and 2008, were enrolled in this study. All the patients failed to receive percutaneous coronary intervention (PCI) within 24 h because of missing the time window. All of them underwent PCI 1 week after the onset of symptoms. Serum high sensitivity C reactive protein (hs-CRP), total bilirubin, LDH and other biomarkers were determined between 24 to 48 h and all the patients received an average of 3 years of follow-up for occurrence of major adverse cardiac events (MACE).
Results Patients with MACE had significant high levels of hs-CRP, LDH, cystatin C, uric acid, creatinine and the ratio of LDH and TB, 2.13±1.32 vs 8.48±3.84 μmol/l, p<0.01, 1151.7±415.4 vs 1355.8±654.3 U/l, p<0.01, 1.00±0.46 vs 1.69±0.76 mg/l, p<0.01, 343.2±108.2 vs 419.6±109.2 μmol/l, p<0.01, 82.1±40.1 vs 104.0±45.6 μmol/l, p<0.01 and 61.2±26.5 vs 141.1±46.2, p<0.01, respectively. In the following multivariate COX analysis, hs-CRP, LDH, cystatin C and the ratio of LDH and TB were significantly associated with the prognosis of these patients.
Conclusions Patients with MACE had a much higher expression of oxidative stress. Elevation of Hs-CRP, LDH, cystatin C and the ratio of LDH and TB were significantly associated with the prognosis of AMI patients undergoing elective PCI.