Effect of serum gamma-glutamyl transferase levels on myocardial perfusion and long-term prognosis after primary angioplasty in patients with acute ST-elevation myocardial infarction.
BACKGROUND
Gamma-glutamyl transferase (GGT) level was found to be elevated in plasma of patients with cardiovascular risk factors. The aim of our study was to assess the relationship between serum GGT levels and the occurrence of no-reflow as well as to evaluate the prognostic value of GGT in ST-segment elevation myocardial infarction (STEMI) population.


RESULTS
One hundred sixty-eight consecutive patients with STEMI who underwent percutaneous coronary intervention (PCI) were enrolled in the study. Patients with STEMI were grouped into tertiles according to their admission serum GGT levels. No-reflow after PCI was assessed both angiographically (thrombolysis in myocardial infarction [TIMI] flow and myocardial blush grade) and electrocardiographically (ST resolution). Gamma-glutamyl transferase levels were higher in patients with STEMI compared to the elective PCI group subjects. Patients with angiographically (TIMI flow ≤2 or TIMI flow 3 with final myocardial bush grade ≤2 after PCI) and electrocardiographically (ST resolution <30%) detected no-reflow were increased in number across the GGT tertiles. In addition, 1-year mortality rates showed a significant increase across the tertile groups (4% vs 11% vs 23%, P < 0.01). Multivariable logistic regression analysis revealed that GGT levels on admission were a significant predictor of long-term mortality of myocardial blush grade-detected no-reflow phenomenon. High GGT level on admission was a significant predictor for long-term mortality and major adverse cardiac events.


CONCLUSIONS
In patients with STEMI undergoing primary PCI, high GGT levels at admission were found to be associated with no-reflow phenomenon and increased long-term mortality.
Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
Firat
F
Ozcan
Mehmet Fatih
MF
Karakas
Mehmet Fatih
MF
Ozlu
Adnan Burak
AB
Akcay
Eyup
E
Buyukkaya
Mustafa
M
Kurt
Gonul
G
Erden
Huseyin
H
Yuzgecer
Metin
M
Yildirimkaya
Edjon
E
Hajro
Yucel
Y
Balbay
Mevlut
M
Koc
Huseyin Ugur
HU
Yazici
Nihat
N
Sen
D000328:Adult; D000368:Aged; D017130:Angioplasty / Q000639:trends*; D015415:Biomarkers / Q000097:blood; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis* / Q000628:therapy; D055414:Myocardial Perfusion Imaging / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome; D005723:gamma-Glutamyltransferase / Q000097:blood*
D015415:Biomarkers; D005723:gamma-Glutamyltransferase; C554782:gamma-glutamyltransferase, human