Sarıkaya Savaş, Aydın Gülay, Yücel Hasan, Kaya Hakkı, Yıldırımlı Kutay, Başaran Ahmet, Zorlu Ali, Sahin Safak, Akyol Lütfü, Bulut Musa
Department of Cardiology, Bozok University and Cumhuriyet University Faculty of Medicine, Yozgat, Turkey.
Department of Cardiology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.
Turk Kardiyol Dern Ars. 2014 Apr;42(3):236-44. doi: 10.5543/tkda.2014.27547.
Our aim was to determine whether there is a relationship between admission gamma-glutamyltransferase (GGT) and subsequent heart failure hospitalizations in patients with acute coronary syndrome.
We selected 123 patients with newly diagnosed acute coronary syndrome of ejection fraction (EF) <45%. Patients were followed 15±10 months, and the relationship between admission GGT level and hospitalization because of heart failure during the follow-up was examined.
Twenty-three (18.7%) patients were hospitalized during the follow-up of 15±10 months. Receiver operating characteristic (ROC) curve analysis showed that the cut-off point of admission GGT related to predict hospitalization was 49 IU/L, with a sensitivity of 81.7% and specificity of 65.2%. Increased GGT >49 IU/L on admission, presence of hypertension and hyperlipidemia, left ventricular ejection fraction (LVEF), right ventricular dysfunction, moderate-to-severe mitral regurgitation, alanine aminotransferase level, and antiplatelet agent usage were found to have prognostic significance in univariate Cox proportional hazards analysis. In multivariate Cox proportional-hazards model, increased GGT >49 IU/L on admission (hazard ratio [HR] 2.663, p=0.047), presence of hypertension (HR 4.107, p=0.007), and LVEF (HR 0.911, p=0.002) were found to be independent factors to predict new-onset heart failure requiring hospitalization.
Hospitalization in heart failure was associated with increased admission GGT levels. Increased admission GGT level in acute coronary syndrome with heart failure should be monitored closely and treated aggressively.
我们的目的是确定急性冠脉综合征患者入院时的γ-谷氨酰转移酶（GGT）与随后发生的心力衰竭住院之间是否存在关联。
我们选取了123例新诊断的射血分数（EF）<45%的急性冠脉综合征患者。对患者进行了15±10个月的随访，并研究了入院时GGT水平与随访期间因心力衰竭住院之间的关系。
在15±10个月的随访期间，有23例（18.7%）患者住院。受试者工作特征（ROC）曲线分析显示，与预测住院相关的入院GGT切点为49 IU/L，敏感性为81.7%，特异性为65.2%。单因素Cox比例风险分析发现，入院时GGT>49 IU/L升高、高血压和高脂血症的存在、左心室射血分数（LVEF）、右心室功能障碍、中重度二尖瓣反流、丙氨酸转氨酶水平以及抗血小板药物的使用具有预后意义。在多因素Cox比例风险模型中，入院时GGT>49 IU/L升高（风险比[HR] 2.663，p=0.047）、高血压的存在（HR 4.107，p=0.007）和LVEF（HR 0.911，p=0.002）被发现是预测需要住院治疗的新发心力衰竭的独立因素。
心力衰竭住院与入院时GGT水平升高有关。对于急性冠脉综合征合并心力衰竭患者，入院时升高的GGT水平应密切监测并积极治疗。
