High admission levels of γ-glutamyltransferase predict poor myocardial perfusion after primary percutaneous intervention.
OBJECTIVE
This retrospective study aimed to investigate the relationship between admission levels of serum y-glutamyltransferase and poor myocardial perfusion after primary percutaneous coronary intervention in patients with acute myocardial infarction.


BACKGROUND
Reperfusion injury caused by free radical release and increased oxidative stress is responsible for the pathophysiology of the no-reflow phenomenon in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention. Serum γ-glutamyltransferase is an established marker of increased oxidative stress.


METHODS
The study population consisted of 80 patients (64 men and 16 women, mean age = 67.5 + 6.6 years) with thrombolysis in myocardial infarction 0/1 flow pre-procedurally. The patients were divided into two groups according to thrombolysis in myocardial perfusion grades that were assessed immediately following primary percutaneous coronary intervention. The two groups (group 1 and group 2) each consisted of 40 patients with thrombolysis in myocardial perfusion grades 0-1 and thrombolysis in myocardial perfusion grades 2-3, respectively.


RESULTS
Admission pain to balloon time, γ-glutamyltransferase and creatine kinase-MB isoenzyme levels of group 1 patients were significantly higher than those of group 2 patients. Pain to balloon time, γ-glutamyltransferase, peak creatine kinase-MB isoenzyme, low left ventricular ejection fraction and poor pre-procedural thrombolysis in myocardial infarction grade were significantly associated with poor myocardial perfusion by univariate analysis. However, only pain to balloon time and γ-glutamyltransferase levels showed a significant independent association with poor myocardial perfusion by backward logistic regression analysis. Adjusted odds ratios were calculated as 4.92 for pain to balloon time and 1.13 for γ-glutamyltransferase.


CONCLUSIONS
High admission γ-glutamyltransferase levels are associated with poor myocardial perfusion in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention, particularly in patients with prolonged pain to balloon time.
Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Etlik-Ankara, Turkey.
Uygar Cagdas
UC
Yuksel
Turgay
T
Celik
Murat
M
Celik
Baris
B
Bugan
Atila
A
Iyisoy
Halil
H
Yaman
D000367:Age Factors; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D052279:Creatine Kinase, MB Form / Q000097:blood; D004452:Echocardiography; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000201:enzymology / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000534:rehabilitation*; D054318:No-Reflow Phenomenon / Q000209:etiology / Q000503:physiopathology; D012189:Retrospective Studies; D015912:Thrombolytic Therapy; D013997:Time Factors; D005723:gamma-Glutamyltransferase / Q000097:blood*
D015415:Biomarkers; D005723:gamma-Glutamyltransferase; D052279:Creatine Kinase, MB Form