Martínez-Quintana Efrén, Pardo-Maiza Javier, Déniz-Alvarado Beatriz, Riaño-Ruiz Marta, González-Martín Jesús María, Rodríguez-González Fayna
Cardiology Department, Complejo Hospitalario Universitario Insular-Materno Infantil, Las Palmas de Gran Canaria, Spain.
Medical and Surgical Sciences Department, Facultad de Ciencias de la Salud, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
Eur J Clin Invest. 2022 Apr;52(4):e13720. doi: 10.1111/eci.13720. Epub 2021 Nov 30.
Serum gamma-glutamyl transferase activity (GGT) seems to predict cardiovascular events in different populations. However, no data exist on patients with congenital heart disease (CHD).
Observational, analytic, prospective cohort study design involving CHD patients and a control population to determine the effect of GGT levels on survival.
A total of 589 CHD patients (58% males, 29 ± 14 years old) and 2745 matched control patients were followed up. A total of 69 (12%) CHD patients had a major acute cardiovascular event (MACE) during the follow-up time (6.1 [0.7-10.4] years). Patients with CHD and a GGT >60 U/L were significantly older, more hypertensive and dyslipidemic, had a worse NYHA functional class and a greater anatomical complexity than CHD patients with a GGT ≤60 U/L. The binary logistic regression analysis showed that age, a great CHD anatomical complexity, and having atrial fibrillation/flutter were the predictive factors of higher GGT levels (>60 U/L). The Kaplan-Meier analysis showed that patients with CHD and a GGT concentration above 60 UL showed the lowest probability of survival compared to that of CHD with GGT ≤60 U/L and controls irrespective of their GGT concentrations (p < .001). Similarly, the multivariable Cox regression analysis found an independent association between higher GGT levels (>60 U/L) and a worse prognosis (HR 2.44 [1.34-4.44], p = .003) among patients with CHD.
Patients with CHD showed significant higher GGT levels than patients in the control group having those with higher GGT concentrations (>60 U/L) the worst survival.
血清γ-谷氨酰转移酶活性（GGT）似乎可预测不同人群的心血管事件。然而，尚无关于先天性心脏病（CHD）患者的数据。
采用观察性、分析性、前瞻性队列研究设计，纳入CHD患者和对照人群，以确定GGT水平对生存的影响。
共随访了589例CHD患者（58%为男性，年龄29±14岁）和2745例匹配的对照患者。在随访期间（6.1[0.7 - 10.4]年），共有69例（12%）CHD患者发生了重大急性心血管事件（MACE）。与GGT≤60 U/L的CHD患者相比，GGT>60 U/L的CHD患者年龄显著更大，高血压和血脂异常情况更严重，纽约心脏协会（NYHA）功能分级更差，解剖结构更复杂。二元逻辑回归分析显示，年龄、CHD解剖结构复杂程度高以及患有心房颤动/扑动是GGT水平较高（>60 U/L）的预测因素。Kaplan-Meier分析显示，与GGT≤60 U/L的CHD患者及对照组相比，无论其GGT浓度如何，GGT浓度高于60 UL的CHD患者生存概率最低（p<0.001）。同样，多变量Cox回归分析发现，在CHD患者中，较高的GGT水平（>60 U/L）与较差的预后独立相关（风险比2.44[1.34 - 4.44]，p = 0.003）。
CHD患者的GGT水平显著高于对照组患者，GGT浓度较高（>60 U/L）的患者生存情况最差。
