title: Prognostic value of gamma-glutamyl transferase in patients with diabetes mellitus and coronary artery disease.
abstract: OBJECTIVE
  The aim of the study was to investigate the association between gamma-glutamyl transferase (GGT) activity and mortality in patients with diabetes mellitus and coronary artery disease (CAD).
  
  
  METHODS
  The study included 1448 patients with diabetes and angiography-proven CAD who underwent percutaneous coronary intervention (PCI). Baseline GGT measurements were available in all patients. The primary outcome was 3-year mortality.
  
  
  RESULTS
  Patients were divided into 3 groups: a group consisting of patients with a GGT activity in the 1st tertile (GGT≤29.4U/L; n=487), a group consisting of patients with a GGT activity in the 2nd tertile (GGT>29.4-52.5U/L; n=479) and a group consisting of patients with GGT in the 3rd tertile (GGT>52.5U/L; n=482). Overall, there were 179 deaths: 46 (11.9%), 49 (12.1%) and 84 deaths (21.4%) among patients of the 1st, 2nd and 3rd GGT tertiles, respectively (adjusted hazard ratio [HR]=1.25, 95% confidence interval [CI] 1.05-1.49, P=0.011). Cardiac death occurred in 101 patients: 22 (5.8%), 30 (7.2%) and 49 deaths (12.9%) among patients of the 1st, 2nd and 3rd GGT tertiles, respectively (adjusted HR=1.23 [0.96-1.58], P=0.104, with risk estimates calculated per standard deviation increase in the logarithmic scale of GGT). GGT improved the risk prediction of models of all-cause (P=0.020) but not cardiac (P=0.135) mortality (P values show the difference in C-statistics between the models without and with GGT).
  
  
  CONCLUSIONS
  In patients with diabetes and CAD treated with PCI, elevated GGT was independently associated with the risk of 3-year all-cause mortality.
authors.affiliation: Department of Adult Cardiology, Deutsches Herzzentrum München, Technische Universität, Munich, Germany. Electronic address: ndrepepa@dhm.mhn.de.
authors.forename: Gjin
authors.initials: G
authors.lastname: Ndrepepa
authors.affiliation: Department of Adult Cardiology, Deutsches Herzzentrum München, Technische Universität, Munich, Germany.
authors.forename: Roisin
authors.initials: R
authors.lastname: Colleran
authors.affiliation: Department of Adult Cardiology, Deutsches Herzzentrum München, Technische Universität, Munich, Germany.
authors.forename: Anke
authors.initials: A
authors.lastname: Luttert
authors.affiliation: Department of Laboratory Medicine, Deutsches Herzzentrum München, Technische Universität, Munich, Germany.
authors.forename: Siegmund
authors.initials: S
authors.lastname: Braun
authors.affiliation: Department of Adult Cardiology, Deutsches Herzzentrum München, Technische Universität, Munich, Germany.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cassese
authors.affiliation: Department of Adult Cardiology, Deutsches Herzzentrum München, Technische Universität, Munich, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kufner
authors.affiliation: Department of Adult Cardiology, Deutsches Herzzentrum München, Technische Universität, Munich, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Hieber
authors.affiliation: Department of Adult Cardiology, Deutsches Herzzentrum München, Technische Universität, Munich, Germany.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Fusaro
authors.affiliation: 1.Medizinische Klinik, Klinikum rechts der Isar, Technische Universität, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
authors.forename: Karl-Ludwig
authors.initials: KL
authors.lastname: Laugwitz
authors.affiliation: Department of Adult Cardiology, Deutsches Herzzentrum München, Technische Universität, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
authors.forename: Heribert
authors.initials: H
authors.lastname: Schunkert
authors.affiliation: Department of Adult Cardiology, Deutsches Herzzentrum München, Technische Universität, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000150:complications / Q000201:enzymology / Q000628:therapy; D048909:Diabetes Complications / Q000201:enzymology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: D005723:gamma-Glutamyltransferase
keywords: Coronary artery disease; Diabetes; Gamma-glutamyl transferase; Mortality