Prognostic values of gamma-glutamyltransferase for patients with acute ST-segment elevation myocardial infarction

AIM: To investigate the prognostic values of serum gamma glutamyl-transferase (GGT) for major adverse cardiac events (MACE) in patients with acute ST-segment elevation myocardial infarction (STEMI) and treatment of emergency percutaneous coronary intervention (PCI). METHODS: One hundred and twelve consecutive STEMI patients who were treated with emergency PCI and were hospitalized in the Department of Cardiology in our hospital were selected from December 2006 to October 2007. Baseline clinical data were collected and serum GGT was measured. MACE was documented during the follow-up and the prognostic values of GGT on MACE were analyzed. RESULTS: ROC curve analysis of the 112 STEMI patients showed that the area under the ROC curve (AUC) of 30 days was 0.576 (P=0.286), AUC of 3 months and 6 months was 0.661 and 0.632 (P=0.011 and 0.029, respectively) and the cut-off point was 28.65 U/L. However, significant difference in age was observed between GGT >28.65 U/L group and GGT<28.65 U/L group (P=0.005). No predictive values of GGT were seen in patients aged≥70 years and the AUC of 30 days, 3 months and 6 months was <0.5, whereas the AUC of 30 days, 3 months and 6 months in patients aged<70 years was 0.669, 0.715 and 0.720, respectively (P=0.048, 0.004 and 0.002, respectively). The cut-off point was 28.65 U/L. According to the cut-off point, patients aged<70 years were divided into two groups and the clinical data of the two groups were comparable (P>0.05). MACE incidence during 30 days, 3 months and 6 months in GGT>28.65U/L group and GGT<28.65U/L group was 28.1% vs. 10.4%, P<0.05, 46.9% vs. 12.5%, P<0.01 and 50.0% vs. 14.6%, P<0.01. The incidence of MACE in GGT>28.65 U/L group was higher than that in GGT<28.65 U/L group. In the two categories of multivariate logistic regression analysis, GGT was an independent predictor of MACE during 3 months and 6 months adjusted by age, sex, multivessel disease, Killip II grade or above, anterior myocardial infarction, CKMB and EF (P<0.05). CONCLUSION: GGT has prognostic value for acute STEMI patients aged <70 years treated with emergency PCI.