title: Increased γ-glutamyl transferase levels predict early mortality in patients with acute pulmonary embolism.
abstract: BACKGROUND
  Increased γ-glutamyl transferase (GGT) level is associated with increased oxidative stress, all-cause mortality, the development of cardiovascular disease, and metabolic syndrome. However, its role in acute pulmonary embolism (PE) is unknown. In this study, we aimed to investigate the relationship between GGT and early mortality in patients with acute PE.
  
  
  METHODS
  A total of 127 consecutive patients with confirmed PE were evaluated. The optimal cutoff value of GGT to predict early mortality was measured as more than 55 IU/L with 94.4% sensitivity and 66.1% specificity. Patients with acute PE were categorized prospectively as having no increased (group I) or increased (group II) GGT based on a cutoff value.
  
  
  RESULTS
  Of these 127 patients, 18 patients (14.2%) died during follow-up. Among these 18 patients, 1 (1.4%) patient was in group I, and 17 (30.9%) patients were in group II (P < .001). γ-Glutamyl transferase level on admission, presence of shock, heart rate, oxygen saturation, right ventricular dilatation/hypokinesia, main pulmonary artery involvement, troponin I, alanine aminotransferase, alkaline phosphatase, and creatinine levels were found to have prognostic significance in univariate analysis. In the multivariate Cox proportional hazards model, GGT level on admission (hazard ratio [HR], 1.015; P = .017), presence of shock (HR, 15.124; P = .005), age (HR, 1.107; P = .010), and heart rate (HR, 1.101; P = .032) remained associated with an increased risk of acute PE-related early mortality after the adjustment of other potential confounders.
  
  
  CONCLUSIONS
  We have shown that a high GGT level is associated with worse hemodynamic parameters, and it seems that GGT helps risk stratification in patients with acute PE.
authors.affiliation: Department of Cardiology, Cumhuriyet University School of Medicine 58140, Sivas, Turkey. dralizorlu@gmail.com
authors.forename: Ali
authors.initials: A
authors.lastname: Zorlu
authors.forename: Hasan
authors.initials: H
authors.lastname: Yucel
authors.forename: Gokhan
authors.initials: G
authors.lastname: Bektasoglu
authors.forename: Kenan Ahmet
authors.initials: KA
authors.lastname: Turkdogan
authors.forename: Umut
authors.initials: U
authors.lastname: Eryigit
authors.forename: Savas
authors.initials: S
authors.lastname: Sarikaya
authors.forename: Meltem Refiker
authors.initials: MR
authors.lastname: Ege
authors.forename: Izzet
authors.initials: I
authors.lastname: Tandogan
authors.forename: Mehmet Birhan
authors.initials: MB
authors.lastname: Yilmaz
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D004452:Echocardiography; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000097:blood / Q000000981:diagnostic imaging / Q000201:enzymology* / Q000401:mortality; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: D005723:gamma-Glutamyltransferase