Implication of liver enzymes on incident cardiovascular diseases and mortality: A nationwide population-based cohort...

Area of Science:

• Cardiovascular Medicine
• Clinical Biochemistry
• Epidemiology

Background:

• Liver enzymes like GGT, ALT, and AST are emerging as potential cardiovascular disease (CVD) risk factors.
• Previous research has not extensively examined their impact on mortality following myocardial infarction (MI) or ischemic stroke (IS).

Purpose of the Study:

• To investigate the association between GGT, ALT, and AST levels and the risk of CVD and all-cause mortality.
• To determine the impact of these liver enzymes on mortality after MI or IS.

Main Methods:

• Analysis of a large-scale, population-based nationwide cohort database of Korean adults.
• Multivariate adjusted models were used to assess relationships during a median 9.1-year follow-up period.
• Examined associations with MI, IS, and all-cause mortality, including 1-year mortality post-MI/IS.

Main Results:

• Both GGT and aminotransferases showed a positive relationship with MI, IS, and mortality.
• ALT and AST exhibited U-shaped associations with mortality, while GGT demonstrated a linear relationship.
• The highest GGT quartile significantly increased 1-year mortality risk post-MI/IS (HR, 1.46).
• GGT's association with CVD and mortality remained significant, independent of traditional cardiovascular risk factors.

Conclusions:

• ALT, AST, and GGT display distinct associations with CVD development and mortality in the Korean population.
• GGT exhibits a robust, independent linear relationship with mortality, both before and after cardiovascular events.
• Elevated GGT levels are a significant predictor of mortality following MI and IS.