Prognostic Value of Serum Gamma-Glutamyl Transferase After Myocardial Infarction
Emdin M, Passino C, Michelassi C, et al. • Eur Heart J
Key Finding
Elevated GGT after MI predicts worse cardiac outcomes
Original title: “Prognostic value of serum gamma-glutamyl transferase activity after myocardial infarction”
Plain English Summary
This study of post-MI patients found that GGT levels predicted subsequent cardiac events and mortality. Patients with elevated GGT had significantly higher rates of cardiac death and heart failure, suggesting GGT may play a direct role in atherosclerotic disease progression rather than being merely a marker.
In-Depth Analysis
Background
Dr. Michele Emdin and colleagues from CNR Institute of Clinical Physiology in Pisa, Italy published this study in the European Heart Journal (PMID: 11549302, DOI: 10.1053/euhj.2001.2751), examining GGT as a prognostic marker after myocardial infarction.
Study Design
Population: 469 consecutive patients hospitalized for acute MI Follow-up: Mean 3.5 years Endpoints: Cardiac death, non-fatal reinfarction, heart failure hospitalization Analysis: Multivariate Cox regression adjusting for traditional risk factors
Key Findings
| GGT Tertile | Cardiac Events | Hazard Ratio |
|---|---|---|
| Lower | 14.2% | 1.0 (reference) |
| Middle | 19.8% | 1.38 (0.82-2.31) |
| Upper | 29.1% | 2.14 (1.30-3.52) |
Key finding: Elevated GGT predicted worse outcomes independently of:
- •Age, sex, diabetes, hypertension
- •LV ejection fraction
- •Alcohol consumption
- •Peak CK-MB
Mechanistic Insights
The authors proposed that GGT directly participates in atherosclerotic plaque progression through:
- •Oxidative stress amplification
- •LDL oxidation within plaques (GGT found in atheromatous lesions)
- •Glutathione depletion indicating antioxidant insufficiency
Clinical Implications
GGT measurement post-MI provides prognostic information beyond traditional markers. Elevated GGT may identify patients requiring more aggressive secondary prevention.
Metabolic Health Perspective
Post-MI elevated GGT likely reflects underlying metabolic dysfunction and oxidative stress. Metabolic interventions (dietary modification, weight loss) can lower GGT while improving overall cardiovascular prognosis.
Paradigm Relevance
How this study applies to different clinical perspectives:
Standard Medical
Conventional clinical guidelines used by most doctors
Not directly relevant to this paradigm
Research Consensus
Current scientific understanding, often ahead of guidelines
Not directly relevant to this paradigm
Metabolic Optimization
Proactive targets for optimal health, not just disease absence
Not directly relevant to this paradigm
Study Details
- Type
- research.studyTypes.observational
Topic
Related Biomarkers
Calculate & Evaluate on Metabolicum
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