Serum gamma-glutamyl transferase activity: new high-risk criteria in acute coronary syndrome patients?

Abstract

In acute coronary syndromes (ACS), oxidation and inflammation have very important roles and in-vitro studies have demonstrated that gamma-glutamyl transferase (GGT) participates in such oxidative and inflammatory reactions. We aimed to evaluate the prognostic value of baseline serum GGT activity on the development of major adverse cardiac event (MACE) in the follow-up of the patients with ACS in coronary care unit (CCU), after 1 and 6 month periods. We included 117 patients (mean age: 61.2+/-11.3 years, 93 males) hospitalized in CCU with the diagnosis of ACS. All had baseline serum GGT activity and were free of systemic and hepatobiliary disease. MACE was defined as the composite of mortality from cardiac causes, recurrent hospitalization with ACS and nonfatal recurrent myocardial infarction diagnoses, to need for coronary revascularization during CCU, over 1 and 6 month follow-up periods. During the follow-up of CCU, MACE occurred in 17 (14.5%) patients (two died). Serum GGT activity was significantly higher in the patients with MACE than those free of MACE (P=0.001) and GGT was found as the independent predictor of the development of MACE-CCU [relative hazard: 1.05, 95% confidence interval (CI): 1.01-1.09, P=0.007]. During the follow-up of 1 month, MACE occurred in 23 (20.0%) patients (five died). Serum GGT activity was significantly higher in patients with MACE than those free of MACE (P=0.021) and GGT was found as the independent predictor of the development of MACE-1 month (relative hazard: 1.04, 95% CI: 1.01-1.08, P=0.039). During the follow-up of 6 months, MACE occurred in 24 (21.8%) patients (two died). Again, GGT was significantly higher in patients who developed MACE than those free of MACE (P=0.001) and GGT was found as the independent predictor of the development of MACE-6 months (relative hazard 1.06, 95% CI: 1.03-1.10, P<0.001). Serum GGT activity was found to be an independent predictor of the development of MACE in the patients with ACS during CCU, over 1 and 6 month follow-up periods.

The relationship between gamma-glutamyltransferase and coronary collateral circulation in patients with chronic total occlusion

“…Similarly, oxidative stress and inflammation modulate the NO system and lead to endothelial dysfunction (38). Serum GGT activity is associated with major cardiovascular events in acute coronary syndrome (39,40). In addition, a significant correlation was demonstrated between serum GGT levels and coronary artery calcification and coronary complexity in stable CAD (41,42).…”

Increased gamma-glutamyl transferase level is associated with absence of coronary collateral vessels in patients with acute coronary syndrome: an observational study

“…other known CAD risk factors as well as alcohol consumption (1)(2)(3)(24)(25)(26)(27). Also in patients with stable CAD, serum GGT was associated with prognosis independent of a variety of established risk markers (28).…”

Can We Use Serum Gamma-Glutamyl Transferase Levels to Predict Early Mortality in Stroke?

“…The patients were evaluated according to their background features such as DM, HT, CAD and previously used medications ( Table-III 25) and median GGT level of alive patients was 22.00 (15.00-35.00). GGT level of dead patients was significantly higher compared to GGT levels of alive patients (p=0.048).…”

“…14 Ulus et al assessed GGT activity and major adverse cardiac event (mortality from cardiac causes, recurrent hospitalization with ACS and nonfatal recurrent MI diagnosis, to need for coronary revascularization during in Coronary Care Unit (CCU)) patients due to acute coronary syndrome for 1-6 months period. 25 They showed that increased GGT activity, even in normal limits, is an independent prognostic factor for adverse cardiac event development in relatively high risk ACS patients. According to our results, high GGT levels are correlated with early mortality in stroke independently of alcohol consumption.…”