Korean Circulation Journal 대한심장학회지 순환기 Kim HL, et al. Korean Circ J. 2022 Feb;52(2):93-109. https://doi.org/10.4070/kcj.2021.0328

Serum alkaline phosphatase (ALP) has been shown to be a prognostic factor in several subgroups of patients due to its promotion of vascular calcification. However, the prognostic impact of serum ALP level in ST-segment elevation myocardial infarction (STEMI) patients with a relatively low calcification burden has not been determined. We aimed to investigate the association of ALP level measured at time of presentation on clinical outcomes in patients with STEMI requiring primary percutaneous coronary intervention (PCI). A total of 1178 patients with STEMI undergoing primary PCI between 2007 and 2014 were retrospectively enrolled from the INTERSTELLAR registry and classified into tertiles by ALP level (83 IU/L). The primary study outcome was a major adverse cardiac or cerebrovascular event (MACCE), defined as the composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, and ischemia-driven revascularization. Median follow-up duration was 25 months (interquartile range, 10–39 months). The incidence of MACCE significantly increased as ALP level increased, that is, for the 83 IU/L tertiles incidences were 8.7%, 11.7%, and 15.7%, respectively; p for trend = 0.003). After adjustment for potential confounders, the adjusted hazard ratios for MACCE in the middle and highest tertiles were 1.69 (95% CI 1.01–2.81) and 2.46 (95% CI 1.48–4.09), respectively, as compared with the lowest ALP tertile. Elevated ALP level at presentation, but within the higher limit of normal, was found to be independently associated with higher risk of MACCE after primary PCI in patients with STEMI.

Kang HJ, et al. Korean Circ J. 2025 Apr;55:e66. https://doi.org/10.4070/kcj.2024.0385

The aim of this study is to investigate sex-related impacts on clinical outcomes after percutaneous coronary intervention (PCI). We analyzed 90,305 patients (29.0% of women) with the first episode of coronary artery disease who underwent PCI from the Korean National Health Insurance claims database between July 2013 and June 2017. Women were significantly older than men (71.5 +/- 10.5 vs. 61.8 +/- 11.7 years, p<0.001). The study population had a median follow-up of 2.2 years (interquartile range, 1.2-3.3). In the propensity-score matched angina population (15,104 pairs), the in-hospital mortality of women was not different from men (odds ratio, 0.87; 95% confidence interval: 0.71-1.08, p=0.202). However, the post-discharge mortality of women was significantly lower (hazard ratio, 0.74; 95% confidence interval: 0.69-0.80, p<0.001) than that of men. In the propensity-score matched acute myocardial infarction (AMI) population (8,775 pairs), the in-hospital mortality of women was significantly higher than that of men (odds ratio, 1.19; 95% confidence interval: 1.05-1.34, p=0.006). Meanwhile, there was no difference in mortality after discharge (hazard ratio, 0.98; 95% confidence interval: 0.91-1.06, p=0.605). The post-discharge mortality of women was not higher than men under the contemporary PCI treatment. Altered sex-related impacts on clinical outcomes might be attributed to improved medical and procedural strategies.

Ha TH, et al. J Cardiovasc Ultrasound. 2011 Dec;19(4):176-182. http://dx.doi.org/10.4250/jcu.2011.19.4.176

Inki Moon, M.D., M.S., Min Gyu Kong, M.D., M.S., Young Sok Ji, M.D., M.S., Se Hyung Kim, M.D., Ph.D., Seong Kyu Park, M.D., Ph.D., Jon Suh, M.D., Ph.D., and Mi-Ae Jang, M.D., Ph.D.. Ann Lab Med 2023;43:145-52. https://doi.org/10.3343/alm.2023.43.2.145