Aspartate aminotransferase-to-platelet ratio index can predict the outcome in patients with stable decompensated cirrhosis.

Autor:	Oikonomou T; Fourth Department of Internal Medicine, Hippokration General Hospital, Medical School of Aristotle University of Thessaloniki, Greece (Theodora Oikonomou, Stefania Kiapidou, Ioannis Goulis)., Chrysavgis L; First Department of Internal Medicine, 'Laiko' General Hospital of Athens, Medical School of National and Kapodistrian University of Athens, Greece (Lampros Chrysavgis, Magdalini Adamantou, Evangelos Cholongitas)., Kiapidou S; Fourth Department of Internal Medicine, Hippokration General Hospital, Medical School of Aristotle University of Thessaloniki, Greece (Theodora Oikonomou, Stefania Kiapidou, Ioannis Goulis)., Adamantou M; First Department of Internal Medicine, 'Laiko' General Hospital of Athens, Medical School of National and Kapodistrian University of Athens, Greece (Lampros Chrysavgis, Magdalini Adamantou, Evangelos Cholongitas)., Parastatidou D; Academic Department of Gastroenterology (Despoina Parastatidou, George V. Papatheodoridis)., Papatheodoridis GV; Academic Department of Gastroenterology (Despoina Parastatidou, George V. Papatheodoridis)., Goulis I; Fourth Department of Internal Medicine, Hippokration General Hospital, Medical School of Aristotle University of Thessaloniki, Greece (Theodora Oikonomou, Stefania Kiapidou, Ioannis Goulis)., Cholongitas E; First Department of Internal Medicine, 'Laiko' General Hospital of Athens, Medical School of National and Kapodistrian University of Athens, Greece (Lampros Chrysavgis, Magdalini Adamantou, Evangelos Cholongitas).
Jazyk:	angličtina
Zdroj:	Annals of gastroenterology [Ann Gastroenterol] 2023 Jul-Aug; Vol. 36 (4), pp. 442-448. Date of Electronic Publication: 2023 May 25.
DOI:	10.20524/aog.2023.0800
Abstrakt:	Background: Platelet (PLT)-based biomarkers have been studied for the evaluation of liver fibrosis and cirrhosis. There are no data regarding their prognostic significance in decompensated cirrhosis. Methods: We studied 525 stable decompensated patients from the 2 Greek transplant centers. We measured PLT values, mean PLT volume (MPV), red cell distribution width, γ-globulins, and calculated PLT-based scores: aspartate aminotransferase-to-PLT ratio index (APRI), γ-globulin-to-PLT model, and γ-glutamyl transpeptidase-to-PLT ratio (GPR). Results: We followed our cohort for 12 (range: 1-84) months. Baseline mean model for end-stage liver disease (MELD) and Child-Turcotte-Pugh (CTP) scores were 15±6 and 8±2, respectively. On univariate analysis, MPV/PLT (hazard ratio [HR] 3.75, 95% confidence interval [CI] 1-14.5; P=0.05), APRI (HR 1.03, 95%CI 1.006-1.06; P=0.016), GPR (HR 1.096, 95%CI 1.016-1.182; P=0.017) were significantly associated with our patients' outcome (survival vs. death or liver transplantation). In a multivariate model without MELD and CTP scores, APRI was the only significant factor associated with the outcome (HR 1.054, 95%CI 1.009-1.101; P=0.018). APRI had good discriminative ability for the outcome (area under the curve 0.723 vs. 0.675 and 0.656 for MELD and CTP scores, respectively). The optimal cutoff point was 1.3 (sensitivity 71%, specificity 65%). There were 200 patients (38%) with APRI scores <1.3 who had better survival than patients with APRI >1.3 (log rank 22.4, P<0.001). Conclusions: This study found a prognostic role for APRI in stable decompensated cirrhosis, regardless of the underlying etiology of chronic liver disease. This suggests new perspectives for PLT-based noninvasive scores to discriminate patients' outcomes. Competing Interests: Conflict of Interest: None (Copyright: © Hellenic Society of Gastroenterology.)
Databáze:	MEDLINE
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