title: Predictive Value of Gamma-Glutamyl Transferase Levels for Contrast-Induced Nephropathy in Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention.
abstract: Contrast-induced nephropathy (CIN) after primary percutaneous coronary intervention (PPCI) is associated with adverse short- and long-term outcomes. The aim of this study was to evaluate the predictive value of gamma-glutamyl transferase (GGT) for risk of CIN in patients with ST-segment elevation myocardial infarction who underwent PPCI. A total of 473 patients were enrolled in the study. A relative increase in serum creatinine ≥25%, or an absolute increase ≥0.5 mg/dl, from the baseline within 72 hours of contrast exposure was defined as CIN. Patients were divided into 3 groups according to GGT tertiles (tertile 1, GGT <19 U/L; tertile 2, GGT 19 to 33 U/L; and tertile 3, GGT >33 U/L) on admission. Demographics, clinical risk factors, laboratory parameters, CIN incidence, and other inhospital clinical outcomes were compared among GGT tertiles. CIN incidence was significantly higher in tertile 3 (29%) compared with tertiles 1 (11%) and 2 (11%, p <0.001). Inhospital death incidence was significantly increased across tertiles (from tertile 1 to tertiles 2 and 3, 1%, 4%, and 5%, respectively, p <0.05). In receiver operating characteristic analysis, a threshold value of GGT >26.5 U/L had 70% sensitivity and 60% specificity for CIN. After including variables found significant in univariate analysis, the presence of diabetes mellitus (odds ratio [OR] 1.71, 95% confidence interval [CI] 1.22 to 2.31, p <0.001), C-reactive protein (for each 1 mg/L increase; OR 1.01, 95% CI 1.00 to 1.02, p = 0.007), contrast volume (for each 1-ml increase; OR 1.01, 95% CI 1.00 to 1.02, p = 0.012), and GGT >26.5 U/L (OR 2.59, 95% CI 1.48 to 4.53, p <0.001) were found as independent associates of CIN in multivariate regression analysis. Each 1 U/L increase in GGT was also associated with CIN risk (OR 1.04, 95% CI 1.03 to 1.06, p <0.001). In conclusion, GGT on admission was a significant and independent predictor of CIN after PPCI in patients with ST-segment elevation myocardial infarction.
authors.affiliation: Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey. Electronic address: foksuz_42@hotmail.com.
authors.forename: Fatih
authors.initials: F
authors.lastname: Oksuz
authors.affiliation: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
authors.forename: Mikail
authors.initials: M
authors.lastname: Yarlioglues
authors.affiliation: Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Cay
authors.affiliation: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
authors.forename: Ibrahim Ethem
authors.initials: IE
authors.lastname: Celik
authors.affiliation: Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Mendi
authors.affiliation: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
authors.forename: Alparslan
authors.initials: A
authors.lastname: Kurtul
authors.affiliation: Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
authors.forename: Tayyar
authors.initials: T
authors.lastname: Cankurt
authors.affiliation: Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Kuyumcu
authors.affiliation: Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
authors.forename: Uğur
authors.initials: U
authors.lastname: Canpolat
authors.affiliation: Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Turak
mesh_terms: D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D003287:Contrast Media / Q000009:adverse effects; D017023:Coronary Angiography / Q000009:adverse effects* / Q000379:methods; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007674:Kidney Diseases / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000000981:diagnostic imaging* / Q000601:surgery; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D002097:C-Reactive Protein; D005723:gamma-Glutamyltransferase