Gamma-glutamyltransferase in acute coronary syndrome patients without ST elevation and its association with stenotic lesion and cardiac events

Coron Artery Dis. 2012 Jan;23(1):39-44. doi: 10.1097/MCA.0b013e32834e4ed0.

Abstract

Background: There are limited data on prognostic value of gamma-glutamyltransferase (GGT) in acute coronary syndromes (ACS) with non-ST-segment elevation (NSTE-ACS). We investigated GGT levels and their association with significant stenosis and major cardiac events (MACE) in NSTE-ACS patients.

Methods and results: This study included 237 patients with NSTE-ACS (ACS group), and age-matched and sex-matched controls with normal coronary arteries (control group). ACS group was divided into subgroups with and without significant stenosis. Serum creatine kinase-MB, troponin T and GGT levels were measured. ACS patients were followed up for MACE (composite of cardiac death, myocardial infarction, recurrent angina, and hospitalization) during 12 months. Median GGT level was higher in ACS group than control group (32 vs. 16 U/l, P=0.001). NSTE-ACS was independently associated with hypertension [odds ratio (OR): 2.83, P=0.001], smoking (OR: 2.19, P=0.015), GGT [OR: 1.16, 95% confidence interval (CI): 1.11-1.21, P=0.001] and ejection fraction (OR: 0.92, P=0.01). GGT level was also higher in patients with significant stenosis than those without significant stenosis (37 vs. 22 U/l, P=0.001). Presence of significant stenosis was independently associated with GGT level (OR: 1.17, 95% CI: 1.12-1.23, P=0.001). At 12 months, MACE-free survival was slightly poor in ACS patients with upper GGT tertile compared with those with lower GGT tertile (77 vs. 97%, P=0.06).

Conclusion: In NSTE-ACS patients, increased GGT levels can be associated with significant stenosis and MACE.

MeSH terms

  • Acute Coronary Syndrome / complications
  • Acute Coronary Syndrome / diagnostic imaging
  • Acute Coronary Syndrome / enzymology*
  • Acute Coronary Syndrome / mortality
  • Aged
  • Angina Pectoris / enzymology
  • Angina Pectoris / etiology
  • Biomarkers / blood
  • Case-Control Studies
  • Chi-Square Distribution
  • Coronary Angiography
  • Coronary Stenosis / complications
  • Coronary Stenosis / diagnostic imaging
  • Coronary Stenosis / enzymology*
  • Coronary Stenosis / mortality
  • Creatine Kinase, MB Form / blood
  • Female
  • Hospitalization
  • Humans
  • Kaplan-Meier Estimate
  • Logistic Models
  • Male
  • Middle Aged
  • Myocardial Infarction / enzymology
  • Myocardial Infarction / etiology
  • Odds Ratio
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Time Factors
  • Troponin T / blood
  • Turkey
  • gamma-Glutamyltransferase / blood*

Substances

  • Biomarkers
  • Troponin T
  • gamma-Glutamyltransferase
  • Creatine Kinase, MB Form