Gamma-glutamyltransferase and prognosis in patients with stable coronary heart disease followed over 8 years

• Published in: Atherosclerosis Vol. 210; no. 2; pp. 649 - 655
• Main Authors: Breitling, L.P, Grandi, N.C, Hahmann, H, Wüsten, B, Rothenbacher, D, Brenner, H
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01.06.2010; Elsevier
• Subjects: Adult; Aged; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular; Cohort Studies; Coronary Disease - blood; Coronary Disease - diagnosis; Coronary heart disease; Coronary heart diseases; Female; Follow-Up Studies; Gamma-glutamyltransferase; gamma-Glutamyltransferase - blood; Gene Expression Regulation, Enzymologic; Heart; Humans; Male; Medical sciences; Middle Aged; Myocardial Infarction - blood; Myocardial Revascularization; Prognosis; Prospective cohort study; Secondary cardiovascular disease; Time Factors; Secondary cardiovascular disease; Coronary heart diseases; Gamma-glutamyltransferase; Prognosis; Prospective cohort study; Vascular disease; Human; Cohort study; Atherosclerosis; Cardiovascular disease; Coronary heart disease
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2009.12.037

Abstract Objectives Serum gamma-glutamyltransferase (γ-GT) predicts incident cardiovascular disease and mortality. The present study examined whether γ-GT also is associated with prognosis in patients with stable coronary heart disease. Methods and results This study included 1152 participants (aged 30–70 years at baseline) of an in-patient rehabilitation programme after acute coronary syndrome, recruited in two rehabilitation clinics in Germany in the years 1999–2000 (KAROLA study). Until year 8 follow-up, 147 participants had experienced a non-fatal or fatal secondary cardiovascular disease event. Confounder-adjusted Cox proportional hazards models revealed an increase in risk for secondary events over ascending γ-GT quartiles, with hazard ratios (95% confidence interval) of 1.21 (0.72–2.03), 1.32 (0.80–2.16) and 1.75 (1.08–2.83) for the 2nd, 3rd and 4th in reference to the lowest quartile ( Ptrend = 0.024). The association with all-cause mortality examined as a secondary outcome was slightly stronger (hazard ratio of 4th quartile: 1.97 [1.15–3.36]; Ptrend = 0.017). Conclusions In patients with stable coronary heart disease, serum γ-GT was associated with prognosis independent of a variety of established risk markers. The association appeared similar to that reported for primary cardiovascular disease, which should motivate additional studies of its clinical utility in cardiovascular patient care.