Prognostic value of serum gamma-glutamyl transferase activity after myocardial infarction

• Published in: European heart journal 2001-10, Vol.22 (19), p.1802-1807
• Main Authors: Emdin, M, Passino, C, Michelassi, C, Titta, F, L'abbate, A, Donato, L, Pompella, A, Paolicchi, A
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; cardiac mortality; Cardiology. Vascular system; Coronary Artery Disease - blood; coronary atherosclerosis; Coronary heart disease; Female; Follow-Up Studies; gamma-Glutamyltransferase - blood; Heart; Humans; Male; Medical sciences; Middle Aged; myocardial infarction; Myocardial Infarction - enzymology; Myocardial Infarction - mortality; Predictive Value of Tests; Prognosis; Proportional Hazards Models; Prospective Studies; Regression Analysis; Risk Factors; ROC Curve; Statistics, Nonparametric; Survival Analysis; γ-GT activity
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1053/euhj.2001.2807

Aims Serum gamma-glutamyl transferase activity (γ-GT) is able to catalyse low-density lipoprotein oxidation and has been detected in coronary atherosclerotic plaques. γ-GT has been documented as an independent risk factor for cardiac mortality in middle-aged men. The purpose of this study is to determine the prognostic value of γ-GT in patients with coronary artery disease. Methods and Results In a prospective study, γ-GT and other cardiac risk factors were evaluated in 469 consecutive subjects with angiographically documented coronary artery disease, using mortality and mortality plus non-fatal myocardial infarction as end-points. γ-GT showed an independent prognostic value beyond known established risk factors in the subgroup of 262 patients with previous myocardial infarction. At a 6-year follow-up, cardiac mortality was 25·2% in patients with γ-GT >40U.l−1vs 13·9% in those with γ-GT 40U.l−1and in 20·4% of those with levels 40U.l−1, previous myocardial infarction, and multiple vessel disease identified a subgroup of 168 patients with the highest risk of cardiac events at 6 years (P=0·024). The relationship between γ-GT levels and cardiac events remained significant after adjustment for cardiac risk factors, and possible confounders, including alcohol consumption. γ-GT did not show significant prognostic value in the 207 patients without previous myocardial infarction. Conclusionγ-GT is an independent cardiac risk factor in ischaemic patients with established coronary atherosclerosis and previous myocardial infarction.