title: The prognostic role of gamma-glutamyltransferase activity in non-diabetic ST-elevation myocardial infarction.
abstract: In patients with acute coronary syndrome, gamma-glutamyltransferase activity (GGT) proved to be an independent predictor of the development of major adverse cardiac events at early and long terms. No data are available on GGT in ST-elevation myocardial infarction (STEMI). We assessed, in 337 consecutive STEMI patients without previously known diabetes submitted to mechanical revascularization, the prognostic role of GGT for in-Intensive Cardiac Care Unit mortality, together with the relation(s) between GGT and acute glucose dysmetabolism (admission glycemia, peak glycemia, insulin resistance as indicated by the Homeostatic Model Assessment HOMA index). At logistic regression analysis, GGT was an independent predictor for in-ICU mortality (OR 1.01 (95% CI 1.003-1.013) p = 0.002), when adjusted for BMI and for major bleedings [(OR 1.005 (95% CI 1.001-1.009) p = 0.029]. At linear regression analyses, GGT was significantly correlated with admission glycemia (r = 0.172; p = 0.002), uric acid (r = 0.146; p = 0.011), insulin (r = 0.171; p = 0.002) and age (r = -0.129; p = 0.020). We document that in STEMI patients without previously known diabetes submitted to mechanical revascularization, GGT values are an independent predictor of early mortality. The significant correlation between GGT and acute glucose dysmetabolism (as indicated by admission glycemia and insulin-resistance) can account, at least in part, for the prognostic role of GGT.
authors.affiliation: Intensive Cardiac Coronary Unit, Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi, University of Florence, VialeMorgagni 85, 50134, Florence, Italy. lazzeric@libero.it
authors.forename: Chiara
authors.initials: C
authors.lastname: Lazzeri
authors.forename: Serafina
authors.initials: S
authors.lastname: Valente
authors.forename: Roberto
authors.initials: R
authors.lastname: Tarquini
authors.forename: Marco
authors.initials: M
authors.lastname: Chiostri
authors.forename: Claudio
authors.initials: C
authors.lastname: Picariello
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Gensini
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000097:blood / Q000201:enzymology*; D011379:Prognosis; D005723:gamma-Glutamyltransferase / Q000097:blood / Q000502:physiology*
chemical_list: D005723:gamma-Glutamyltransferase