title: The relationship between saphenous coronary bypass graft occlusion and serum gamma-glutamyltransferase activity.
abstract: OBJECTIVE
  Serum gamma-glutamyltransferase (GGT) activity has been shown to be associated with progression of atherosclerosis. We evaluated the relationship between serum GGT levels and saphenous vein bypass graft disease at least one year after coronary artery bypass graft (CABG) surgery.
  
  
  METHODS
  The study included 125 consecutive patients who had undergone CABG surgery with at least one saphenous vein graft (SVG) and were referred to cardiac catheterization for stable anginal symptoms or positive stress test results at least one year after CABG surgery. Laboratory parameters including serum GGT levels were measured before angiography. Occluded grafts were defined as a luminal stenosis of ≥70% or absence of distal TIMI 3 flow. Thus, SVGs were found to be patent in 53 patients (42.4%; 40 males, 13 females; mean age 65±8 years) and occluded in 72 patients (57.6%; 62 males, 10 females; mean age 64±9 years).
  
  
  RESULTS
  The two groups were similar with regard to age, gender, hypertension, diabetes mellitus, family history of coronary artery disease, smoking, and alcohol consumption. The mean time from CABG to angiography was similar in patients with a patent and occluded SVG (6.8±4.3 vs. 8.1±3.7 years; p>0.05). Waist circumference was greater (p=0.02) and serum levels of total cholesterol (p=0.001), triglyceride (p=0.02), uric acid (p<0.001), hs-CRP (p<0.001), GGT (p<0.001) and fibrinogen (p<0.001) were significantly higher in patients with occluded veins. Serum GGT level was moderately but significantly correlated with waist circumference (r=0.2, p=0.04), uric acid (r=0.3, p=0.008), and hs-CRP (r=0.3, p=0.002). In logistic regression analysis, total cholesterol (OR=1.012, 95% CI 1.002-1.023, p=0.03), hs-CRP (OR=1.968, 95% CI 1.17-3.311, 0.01), uric acid (OR=1.57, 95% CI 1.1-2.208, p=0.01), and GGT (OR=1.047, 95% CI 1.002-1.1, p=0.04) were found to be significant predictors of SVG occlusion.
  
  
  CONCLUSIONS
  Our results suggest that serum GGT activity is associated with higher occlusion rates of venous bypass grafts.
authors.affiliation: Department of Cardiology, Türkiye Yüksek İhtisas Heart-Education and Research Hospital, Ankara, Turkey. burcume@gmail.com
authors.forename: Burcu
authors.initials: B
authors.lastname: Demirkan
authors.forename: Yeşim
authors.initials: Y
authors.lastname: Güray
authors.forename: Ümit
authors.initials: Ü
authors.lastname: Güray
authors.forename: Osman
authors.initials: O
authors.lastname: Turak
authors.forename: Edjon
authors.initials: E
authors.lastname: Hajro
authors.forename: Sule
authors.initials: S
authors.lastname: Korkmaz
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D002784:Cholesterol / Q000097:blood; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000097:blood / Q000201:enzymology / Q000601:surgery*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000097:blood / Q000201:enzymology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012501:Saphenous Vein / Q000473:pathology / Q000637:transplantation*; D014527:Uric Acid / Q000097:blood; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: D014527:Uric Acid; D002097:C-Reactive Protein; D002784:Cholesterol; D005723:gamma-Glutamyltransferase