Gamma‐glutamyl transferase to albumin ratio as a novel predictor of bleeding events and mortality in patients after percutaneous coronary intervention: A retrospective cohort study

Abstract

Objectives To determine whether gamma‐glutamyl transferase (GGT) to albumin ratio (GAR) independently predicts mortality and bleeding events in coronary artery disease (CAD) patients who undergo percutaneous coronary intervention (PCI). Background Serum GGT and albumin levels have been associated with CAD risk and mortality. However, more analysis is needed to determine their predictive relationship with adverse outcomes. Methods In total, 5,638 patients from a large retrospective cohort study were enrolled from January 2008 to December 2016 and divided into two groups (GAR <0.62, n = 2,712 and GAR ≥0.62, n = 2,926). The average follow‐up time was 35.9 ± 22.6 months. Multivariate Cox regression analyses were performed to determine the risk of all‐cause mortality and bleeding events associated with GAR. Results The low‐GAR group had a significantly higher number of all‐cause mortality (p = .016) and bleeding events (p = .010) than the high‐GAR group. Multivariate Cox regression analyses showed that the risk of all‐cause death and bleeding events decreased by 23.8% (hazard risk [HR] = 0.762 95% confidence interval [CI]: 0.601–0.966, p = .025) and 39.4% (HR = 00.616, 95% CI: 0.446–0.852, p = .003), respectively, in the high‐GAR group. In patients with acute coronary syndrome, the risk of bleeding events decreased by 57.3% in the high‐GAR group (HR = 0.427, 95% CI: 0.234–0.781, p = .006). In patients with stable coronary heart disease, the risk of all‐cause death decreased 28.6% (HR = 0.714, 95% CI: 0.540–0.944, p = .018) in the high‐GAR group. Conclusion GAR was an independent and novel predictor of mortality and bleeding events in CAD patients who underwent PCI.

An elevated monocyte-to-high-density lipoprotein–cholesterol ratio is associated with mortality in patients with coronary artery disease who have undergone PCI

“…The routine blood samples were measured using an automated blood counter within 2 h of collection to minimize variations due to sample aging. We measured the serum concentrations of uric acid, total cholesterol, triglycerides, blood urea nitrogen (BUN), creatinine (Cr), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and fasting glucose using chemical analysis equipment (Dimension AR/AVL Clinical Chemistry System, Newark, NJ) in the Clinical Laboratory Department of the First Affiliated Hospital of Xinjiang Medical University, as described previously [17].…”

Gamma-glutamyl transferase and cardiovascular disease risk

“…The study observed in patients with stable CAD a decrease in the risk of mortality from different causes by 28.6% in patients with high albumin ratio. The albumin ratio was considered as an independent and new predictor of mortality and bleeding events in patients with CAD undergoing percutaneous coronary intervention [36].…”

ADS Score as a Novel Predictor of Outcomes in Patients Who Underwent Percutaneous Coronary Intervention

“…The levels of these biomarkers can reflect the degree of chronic inflammation in CAD patients. Previously, several inflammatory biomarkers, such as neutrophil to lymphocyte ratio (NLR) ( 7 , 8 ), derived neutrophil to lymphocyte ratio (dNLR), fibrinogen (Fib) ( 9 – 12 ), and albumin (Alb) ( 13 , 14 ), have been reported to be associated with the progress and prognosis of CAD. Fib is one of the vital elements in the coagulation cascade, and hypercoagulation is commonly occurred in CAD patients ( 15 ).…”

“…Fib is one of the vital elements in the coagulation cascade, and hypercoagulation is commonly occurred in CAD patients ( 15 ). Meanwhile, hypoalbuminemia was reported to be associated with outcomes of CAD ( 13 , 14 ). Previous studies also suggested the ratio of Fib to albumin (FAR) was an independent predictor of CAD after percutaneous coronary intervention (PCI) ( 11 , 16 ).…”