HealthDay News — Alanine aminotransferase (ALT) levels within normal range are associated with cardiovascular event risk, according to a study published in the July 1 issue of The American Journal of Cardiology.

Paulo H.N. Harada, MD, MPH, PhD, from Harvard Medical School in Boston, and colleagues examined the correlation between hepatic serum markers in the normal range and cardiovascular risk. Data were included for 17,515 men and women free from cardiovascular disease with a baseline level of ALT below 40 IU/L who were followed for the first-ever cardiovascular event.

The researchers observed an inverse correlation between ALT levels at study entry and age, smoking status, and inflammation, and a positive association for ALT levels with male gender, alcohol use, and triglycerides. Participants in the lowest tertile of baseline ALT had the highest incident cardiovascular event rates; for those in the lowest, middle, and highest tertile of baseline ALT within the normal range, incidence rates were 1.43, 0.98, and 0.85 per 100 person-years of exposure, respectively (P < 0.001). After multivariable adjustment for a wide range of vascular risk factors, these inverse effects remained statistically significant. Baseline ALT therapy did not modify the efficacy of statin therapy.

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“Increasing ALT levels within the normal range are inversely associated with future cardiovascular risk but had limited clinical utility and also did not modify the efficacy of statin therapy,” the authors write.

Two authors disclosed financial ties to pharmaceutical companies, including AstraZeneca, which funded the study.


  1. Harada PHN, Cook NR, Cohen DE, et al. Relation of alanine aminotransferase levels to cardiovascular events and statin efficacy. Am J Cardiol. 2016;118(1):49-55; doi: 10.1016/j.amcard.2016.04.012