Emdin M, Passino C, Michelassi C, Titta F, L'abbate A, Donato L, Pompella A, Paolicchi A
CNR Institute of Clinical Physiology, National Research Council, Pisa, Italy.
Eur Heart J. 2001 Oct;22(19):1802-7. doi: 10.1053/euhj.2001.2807.
Serum gamma-glutamyl transferase activity (gamma-GT) is able to catalyse low-density lipoprotein oxidation and has been detected in coronary atherosclerotic plaques. gamma-GT has been documented as an independent risk factor for cardiac mortality in middle-aged men. The purpose of this study is to determine the prognostic value of gamma-GT in patients with coronary artery disease.
In a prospective study, gamma-GT and other cardiac risk factors were evaluated in 469 consecutive subjects with angiographically documented coronary artery disease, using mortality and mortality plus non-fatal myocardial infarction as end-points. gamma-GT showed an independent prognostic value beyond known established risk factors in the subgroup of 262 patients with previous myocardial infarction. At a 6-year follow-up, cardiac mortality was 25.2% in patients with gamma-GT >40 U x l(-1)vs 13.9% in those with gamma-GT <40 U x l(-1)(P=0.038). When both cardiac mortality and non-fatal myocardial infarction were considered as end-points, these events were recorded in 32.7% of patients with gamma-GT >40 U x l(-1)and in 20.4% of those with levels <40 U x l(-1)(P=0.031). Excess mortality and non-fatal infarction in patients with high gamma-GT levels were concentrated in the first 2 years of follow-up (P=0.014). The association of gamma-GT values >40 U x l(-1), previous myocardial infarction, and multiple vessel disease identified a subgroup of 168 patients with the highest risk of cardiac events at 6 years (P=0.024). The relationship between gamma-GT levels and cardiac events remained significant after adjustment for cardiac risk factors, and possible confounders, including alcohol consumption. gamma-GT did not show significant prognostic value in the 207 patients without previous myocardial infarction.
gamma-GT is an independent cardiac risk factor in ischaemic patients with established coronary atherosclerosis and previous myocardial infarction.
血清γ-谷氨酰转移酶活性（γ-GT）能够催化低密度脂蛋白氧化，且已在冠状动脉粥样硬化斑块中检测到。γ-GT已被证明是中年男性心脏死亡的独立危险因素。本研究的目的是确定γ-GT在冠心病患者中的预后价值。
在一项前瞻性研究中，对469例经血管造影证实患有冠状动脉疾病的连续受试者进行了γ-GT和其他心脏危险因素评估，以死亡以及死亡加非致命性心肌梗死作为终点。在262例既往有心肌梗死的患者亚组中，γ-GT显示出超越已知既定危险因素的独立预后价值。在6年随访时，γ-GT>40 U×l⁻¹的患者心脏死亡率为25.2%，而γ-GT<40 U×l⁻¹的患者为13.9%（P=0.038）。当将心脏死亡和非致命性心肌梗死均视为终点时，这些事件在γ-GT>40 U×l⁻¹的患者中记录为32.7%，而在水平<40 U×l⁻¹的患者中为20.4%（P=0.031）。γ-GT水平高的患者的额外死亡和非致命性梗死集中在随访的前2年（P=0.014）。γ-GT值>40 U×l⁻¹、既往心肌梗死和多支血管病变的联合确定了一个168例患者的亚组，其在6年时发生心脏事件的风险最高（P=0.024）。在对心脏危险因素以及包括饮酒在内的可能混杂因素进行调整后，γ-GT水平与心脏事件之间的关系仍然显著。γ-GT在207例无既往心肌梗死的患者中未显示出显著的预后价值。
γ-GT是患有已确诊冠状动脉粥样硬化和既往心肌梗死的缺血性患者的独立心脏危险因素。
