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Gamma-glutamyl transferase and prognosis in patients with coronary artery disease
Gjin Ndrepepa1, Siegmund Braun1, Heribert Schunkert2
1Deutsches Herzzentrum München, Technische Universität, Munich, Germany.
Insights
Elevated gamma-glutamyl transferase (GGT) levels in patients with coronary artery disease (CAD) predict higher 3-year mortality risk. GGT offers additional prognostic value for all-cause and non-cardiac mortality beyond traditional risk factors.
Area of Science:
- Cardiology
- Biochemistry
- Clinical Prediction
Background:
- The prognostic implications of gamma-glutamyl transferase (GGT) activity in patients with coronary artery disease (CAD) are not well understood.
- Investigating GGT's role can enhance risk stratification for CAD patients.
Purpose of the Study:
- To determine the association between gamma-glutamyl transferase (GGT) activity and 3-year mortality in patients with coronary artery disease (CAD).
- To assess whether GGT provides incremental prognostic information for mortality prediction in CAD.
Main Methods:
- A cohort of 5501 patients with CAD undergoing percutaneous coronary intervention with available GGT measurements was analyzed.
- The primary endpoint was 3-year all-cause mortality, with secondary analyses for cardiac and non-cardiac mortality.
Main Results:
- Higher GGT activity tertiles were significantly associated with increased 3-year all-cause mortality (P<0.001).
- Elevated GGT independently predicted higher risks of all-cause (HR=1.30), cardiac (HR=1.21), and non-cardiac mortality (HR=1.42).
- GGT improved the prediction of all-cause and non-cardiac mortality but not cardiac mortality.
Conclusions:
- Elevated GGT activity is a significant independent predictor of increased 3-year all-cause, cardiac, and non-cardiac mortality in patients with CAD.
- GGT offers incremental prognostic value for predicting all-cause and non-cardiac mortality in CAD patients, complementing existing risk factors.
Background:
The association between gamma-glutamyl transferase (GGT) activity and outcome of patients with coronary artery disease (CAD) remains poorly investigated.
Methods:
The study included 5501 patients with CAD treated with percutaneous coronary intervention and GGT measurements available. The primary outcome was 3-year mortality.
Results:
GGT activity tertiles were: 1st tertile (GGT<28.10U/L; n=1866), 2nd tertile (GGT≥28.10U/L to49.50U/L; n=1804) and 3rd tertile (GG>49.50U/L; n=1831). There were 110 deaths in the 1st, 111 deaths in the 2nd and 216 deaths in the 3rd GGT tertile (mortality estimates, 7.1%, 7.2% and 13.9%; P<0.001). GGT was independently associated with the increased risk of 3-year all-cause (adjusted hazard ratio [HR]=1.30, 95% confidence interval [CI] 1.18 to 1.44, P<0.001), cardiac (HR=1.21 [1.06-1.39], P=0.005) and non-cardiac (HR=1.42 [1.23-1.63], P<0.001) mortality (all risk estimates calculated per standard deviation increase in the log GGT activity). GGT improved prediction of all-cause (P<0.001) and non-cardiac mortality (P<0.001) but not cardiac mortality (P=0.155).
Conclusions:
In patients with CAD, elevated GGT activity is associated with increased risk of 3-year all-cause, cardiac and non-cardiac mortality. GGT provided incremental prognostic information on top of cardiovascular and metabolic risk factors for prediction of all-cause and non-cardiac mortality but not cardiac mortality.
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