Alkaline Phosphatase Predicts Short-term Postoperative Outcome in Adult Patients with Moyamoya Disease

Wei Sun¹Huihui Wang²Qiheng He¹Junsheng Li¹Chenglong Liu¹Zhiyao Zheng¹Siqi Mou¹Bojian Zhang¹Zhikang Zhao¹Chuming Tao¹Wei Liu¹Xiangjun Shi¹Yan Zhang¹Peicong Ge^1*Dong Zhang^3*Jun Wu^1*

• ¹Beijing Tiantan Hospital, Capital Medical University, Beijing, China
• ²Department of Hematology, Second Xiangya Hospital, Central South University, Changsha, Anhui Province, China
• ³Beijing Hospital, Beijing, Beijing, China

Background: Alkaline phosphatase (ALP) has played a pivotal role in vascular diseases in recent years. However, the association between ALP level and postoperative complications of moyamoya disease (MMD) has not been studied. Patients and Methods: Blood samples were collected from recruited patients with MMD. The serum ALP concentrations of the patients were determined using non-frozen specimens via an automated enzymatic assay. Patients were then divided into two groups according to the median, and a comparative analysis was performed. Patients were stratified into two cohorts for statistical evaluation based on the occurrence of postoperative stroke events. We employed a nomogram to identify risk factors for postoperative events. We also created a Cox model to analyze the risk factors for postoperative stroke events, including ALP. Furthermore, we plotted a restricted cubic spline (RCS) of ALP concentration versus postoperative stroke events. Results: We could find that the ALP concentration of non-postoperative stroke group and postoperative stroke group was 68.70 U/L and 71.15 U/L. This nomogram showed that ALP was a risk factor for postoperative events, and the Hosmer-Lemeshow goodness-of-fit test was employed, suggesting that the model was reliable (χ2 = 8.507, p = 0.386). And it also could obverse that there was a statistically positive correlation from the RCS between ALP concentration and postoperative stroke events Cox analysis (HR = 1.006, 95% CI = 1.002 – 1.010, p = 0.008). Conclusions: ALP levels may predict the short-term postoperative outcomes of MMD patients undergoing surgical treatment.