Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China.
Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Catheter Cardiovasc Interv. 2020 Feb;95 Suppl 1:572-578. doi: 10.1002/ccd.28696. Epub 2020 Jan 8.
To determine whether gamma-glutamyl transferase (GGT) to albumin ratio (GAR) independently predicts mortality and bleeding events in coronary artery disease (CAD) patients who undergo percutaneous coronary intervention (PCI).
Serum GGT and albumin levels have been associated with CAD risk and mortality. However, more analysis is needed to determine their predictive relationship with adverse outcomes.
In total, 5,638 patients from a large retrospective cohort study were enrolled from January 2008 to December 2016 and divided into two groups (GAR <0.62, n = 2,712 and GAR ≥0.62, n = 2,926). The average follow-up time was 35.9 ± 22.6 months. Multivariate Cox regression analyses were performed to determine the risk of all-cause mortality and bleeding events associated with GAR.
The low-GAR group had a significantly higher number of all-cause mortality (p = .016) and bleeding events (p = .010) than the high-GAR group. Multivariate Cox regression analyses showed that the risk of all-cause death and bleeding events decreased by 23.8% (hazard risk [HR] = 0.762 95% confidence interval [CI]: 0.601-0.966, p = .025) and 39.4% (HR = 00.616, 95% CI: 0.446-0.852, p = .003), respectively, in the high-GAR group. In patients with acute coronary syndrome, the risk of bleeding events decreased by 57.3% in the high-GAR group (HR = 0.427, 95% CI: 0.234-0.781, p = .006). In patients with stable coronary heart disease, the risk of all-cause death decreased 28.6% (HR = 0.714, 95% CI: 0.540-0.944, p = .018) in the high-GAR group.
GAR was an independent and novel predictor of mortality and bleeding events in CAD patients who underwent PCI.
确定γ-谷氨酰转移酶（GGT）与白蛋白比值（GAR）是否能独立预测行经皮冠状动脉介入治疗（PCI）的冠心病（CAD）患者的死亡率和出血事件。
血清 GGT 和白蛋白水平与 CAD 风险和死亡率相关。然而，需要更多的分析来确定它们与不良结局的预测关系。
本研究共纳入了一项大型回顾性队列研究中的 5638 例患者，这些患者于 2008 年 1 月至 2016 年 12 月被分为两组（GAR＜0.62，n=2712 和 GAR≥0.62，n=2926）。平均随访时间为 35.9±22.6 个月。采用多变量 Cox 回归分析确定 GAR 与全因死亡率和出血事件相关的风险。
低 GAR 组的全因死亡率（p=0.016）和出血事件（p=0.010）显著高于高 GAR 组。多变量 Cox 回归分析显示，全因死亡和出血事件的风险分别降低了 23.8%（风险比[HR]为 0.762，95%置信区间[CI]为 0.601-0.966，p=0.025）和 39.4%（HR 为 0.616，95%CI 为 0.446-0.852，p=0.003），风险降低幅度与 GAR 水平呈正相关。在急性冠状动脉综合征患者中，高 GAR 组出血事件的风险降低了 57.3%（HR 为 0.427，95%CI 为 0.234-0.781，p=0.006）。在稳定性冠心病患者中，高 GAR 组的全因死亡率降低了 28.6%（HR 为 0.714，95%CI 为 0.540-0.944，p=0.018）。
GAR 是行 PCI 的 CAD 患者死亡率和出血事件的独立且新颖的预测因子。
