Gjin Ndrepepa1, Roisin Colleran2, Anke Luttert2, Siegmund Braun3, Salvatore Cassese2, Sebastian Kufner2, Julia Hieber2, Massimiliano Fusaro2, Karl-Ludwig Laugwitz4, Heribert Schunkert5, Adnan Kastrati5. 1. Department of Adult Cardiology, Deutsches Herzzentrum München, Technische Universität, Munich, Germany. Electronic address: ndrepepa@dhm.mhn.de. 2. Department of Adult Cardiology, Deutsches Herzzentrum München, Technische Universität, Munich, Germany. 3. Department of Laboratory Medicine, Deutsches Herzzentrum München, Technische Universität, Munich, Germany. 4. 1.Medizinische Klinik, Klinikum rechts der Isar, Technische Universität, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany. 5. Department of Adult Cardiology, Deutsches Herzzentrum München, Technische Universität, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
Abstract
OBJECTIVES: 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). DESIGN AND 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). CONCLUSION: In patients with diabetes and CAD treated with PCI, elevated GGT was independently associated with the risk of 3-year all-cause mortality.
OBJECTIVES: 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). DESIGN AND 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). CONCLUSION: In patients with diabetes and CAD treated with PCI, elevated GGT was independently associated with the risk of 3-year all-cause mortality.
Authors: Da Young Lee; Kyungdo Han; Ji Hee Yu; Sanghyun Park; Ji A Seo; Nam Hoon Kim; Hye Jin Yoo; Sin Gon Kim; Seon Mee Kim; Kyung Mook Choi; Sei Hyun Baik; Yong Gyu Park; Nan Hee Kim Journal: Sci Rep Date: 2020-09-21 Impact factor: 4.379