title: Can we use serum gamma-glutamyl transferase levels to predict early mortality in stroke?
abstract: OBJECTIVE
  Serum gamma-glutamyl transferase (GGT) is a marker for alcohol consumption and hepatobiliary diseases. There are reports on the prognostic role of GGT in coronary artery diseases and stroke. The aim of our study was to identify the potential differences in GGT levels in different types of stroke, and to evaluate the correlation between GGT and 30-day mortality.
  
  
  METHODS
  Patients diagnosed with stroke in emergency department between 01.01.2010 and 30.12.2012 was included in the study. Imaging techniques were used to distinguish between hemorrhagic and ischemic stroke. Ischemic strokes were further classified as either atherosclerotic/lacunar or embolic. Parameters including age, gender, vital signs (systolic and diastolic blood pressure), comorbid diseases (HT, DM, CAD, smoking and alcohol consumption), used medications, previous history of stroke, NIHSS score at the time of admission to emergency department, laboratory parameters (glucose, white blood cell count, hemoglobin, platelet, total cholesterol, creatinine) and duration of hospitalization were recorded. Death records were obtained from patients' medical records.
  
  
  RESULTS
  One thousand eighty six patients were included in the study. GGT levels were not significantly different between ischemic and hemorrhagic strokes (p=0.435). On the other hand, GGT levels in embolic strokes were significantly higher compared to atherosclerotic/lacunar strokes (p=0.001). GGT levels [median 24.50 (16.00-43.00)] in Intensive Care Unit patients were significantly higher compared to GGT level [22.00 (15.00-34.25)] in admitted to service beds patients (p=0.015). Median GGT level of deceased patients was 24.00 (16.00-41.25) and median GGT level of alive patients was 22.00 (15.00-35.00). GGT level of deceased patients was significantly higher compared to GGT levels of alive patients (p=0.048).
  
  
  CONCLUSIONS
  There was no difference in GGT levels between ischemic and hemorrhagic strokes; however, GGT levels in embolic strokes were significantly higher compared to atherosclerotic/lacunar strokes. High GGT levels are correlated with early mortality in stroke. We believe that GGT may be used as a predictor of mortality in future studies.
authors.affiliation: Emine Akinci, Keçiören Training and Research Hospital, Emergency Department, Ankara, Turkey.
authors.forename: Emine
authors.initials: E
authors.lastname: Akinci
authors.affiliation: Nurettin Özgür Doğan, Kocaeli University Medicine Faculty, Emergency Department, Kocaeli, Turkey.
authors.forename: Nurettin Özgür
authors.initials: NÖ
authors.lastname: Doğan
authors.affiliation: Haluk Gümüş, KonyaTraining and Research Hospital, Neurology Department, Konya, Turkey.
authors.forename: Haluk
authors.initials: H
authors.lastname: Gümüş
authors.affiliation: Nazire belgin Akilli, KonyaTraining and Research Hospital, Emergency Department, Konya, Turkey.
authors.forename: Nazire Belgin
authors.initials: NB
authors.lastname: Akilli
keywords: GGT; Mortality; Stroke