Gamma-glutamyltransferase and prognosis in patients with stable coronary heart disease followed over 8 years.
OBJECTIVE
Serum gamma-glutamyltransferase (gamma-GT) predicts incident cardiovascular disease and mortality. The present study examined whether gamma-GT also is associated with prognosis in patients with stable coronary heart disease.


RESULTS
This study included 1152 participants (aged 30-70 years at baseline) of an in-patient rehabilitation programme after acute coronary syndrome, recruited in two rehabilitation clinics in Germany in the years 1999-2000 (KAROLA study). Until year 8 follow-up, 147 participants had experienced a non-fatal or fatal secondary cardiovascular disease event. Confounder-adjusted Cox proportional hazards models revealed an increase in risk for secondary events over ascending gamma-GT quartiles, with hazard ratios (95% confidence interval) of 1.21 (0.72-2.03), 1.32 (0.80-2.16) and 1.75 (1.08-2.83) for the 2nd, 3rd and 4th in reference to the lowest quartile (Ptrend=0.024). The association with all-cause mortality examined as a secondary outcome was slightly stronger (hazard ratio of 4th quartile: 1.97 [1.15-3.36]; Ptrend=0.017).


CONCLUSIONS
In patients with stable coronary heart disease, serum gamma-GT was associated with prognosis independent of a variety of established risk markers. The association appeared similar to that reported for primary cardiovascular disease, which should motivate additional studies of its clinical utility in cardiovascular patient care.
Breitling
L P
LP
Division of Clinical Epidemiology and Aging Research C070, German Cancer Research Center, Bergheimer Str 20, 69115 Heidelberg, Germany. L.Breitling@dkfz-heidelberg.de
Grandi
N C
NC
Hahmann
H
H
Wüsten
B
B
Rothenbacher
D
D
Brenner
H
H
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003327:Coronary Disease / Q000097:blood* / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D015971:Gene Expression Regulation, Enzymologic; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood; D009204:Myocardial Revascularization; D011379:Prognosis; D013997:Time Factors; D005723:gamma-Glutamyltransferase / Q000097:blood*
D005723:gamma-Glutamyltransferase