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. 2011;66(10):1729-34.
doi: 10.1590/s1807-59322011001000010.

High admission levels of γ-glutamyltransferase predict poor myocardial perfusion after primary percutaneous intervention

Uygar Cagdas Yuksel  1 , Turgay Celik, Murat Celik, Baris Bugan, Atila Iyisoy, Halil Yaman
Affiliations

High admission levels of γ-glutamyltransferase predict poor myocardial perfusion after primary percutaneous intervention

Uygar Cagdas Yuksel et al. Clinics (Sao Paulo). 2011.

Abstract

Objective: This retrospective study aimed to investigate the relationship between admission levels of serum y-glutamyltransferase and poor myocardial perfusion after primary percutaneous coronary intervention in patients with acute myocardial infarction.

Introduction: Reperfusion injury caused by free radical release and increased oxidative stress is responsible for the pathophysiology of the no-reflow phenomenon in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention. Serum γ-glutamyltransferase is an established marker of increased oxidative stress.

Methods: The study population consisted of 80 patients (64 men and 16 women, mean age = 67.5 + 6.6 years) with thrombolysis in myocardial infarction 0/1 flow pre-procedurally. The patients were divided into two groups according to thrombolysis in myocardial perfusion grades that were assessed immediately following primary percutaneous coronary intervention. The two groups (group 1 and group 2) each consisted of 40 patients with thrombolysis in myocardial perfusion grades 0-1 and thrombolysis in myocardial perfusion grades 2-3, respectively.

Results: Admission pain to balloon time, γ-glutamyltransferase and creatine kinase-MB isoenzyme levels of group 1 patients were significantly higher than those of group 2 patients. Pain to balloon time, γ-glutamyltransferase, peak creatine kinase-MB isoenzyme, low left ventricular ejection fraction and poor pre-procedural thrombolysis in myocardial infarction grade were significantly associated with poor myocardial perfusion by univariate analysis. However, only pain to balloon time and γ-glutamyltransferase levels showed a significant independent association with poor myocardial perfusion by backward logistic regression analysis. Adjusted odds ratios were calculated as 4.92 for pain to balloon time and 1.13 for γ-glutamyltransferase.

Conclusion: High admission γ-glutamyltransferase levels are associated with poor myocardial perfusion in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention, particularly in patients with prolonged pain to balloon time.

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Conflict of interest statement

No potential conflict of interest was reported.

Figures

Figure 1
Figure 1
Comparison of Gamma-glutamyltransferase levels between study groups. (TMPG: TIMI myocardial perfusion grade).
Figure 2
Figure 2
ROC curve of Gamma-glutamyltransferase for predicting no-reflow. (AUC: area under curve).
See this image and copyright information in PMC

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