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Atherosclerosis. 2010 Jun;210(2):649-55. doi: 10.1016/j.atherosclerosis.2009.12.037. Epub 2010 Jan 11.

Gamma-glutamyltransferase and prognosis in patients with stable coronary heart disease followed over 8 years.

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Division of Clinical Epidemiology and Aging Research C070, German Cancer Research Center, Bergheimer Str 20, 69115 Heidelberg, Germany.



Serum gamma-glutamyltransferase (gamma-GT) predicts incident cardiovascular disease and mortality. The present study examined whether gamma-GT also is associated with prognosis in patients with stable coronary heart disease.


This study included 1152 participants (aged 30-70 years at baseline) of an in-patient rehabilitation programme after acute coronary syndrome, recruited in two rehabilitation clinics in Germany in the years 1999-2000 (KAROLA study). Until year 8 follow-up, 147 participants had experienced a non-fatal or fatal secondary cardiovascular disease event. Confounder-adjusted Cox proportional hazards models revealed an increase in risk for secondary events over ascending gamma-GT quartiles, with hazard ratios (95% confidence interval) of 1.21 (0.72-2.03), 1.32 (0.80-2.16) and 1.75 (1.08-2.83) for the 2nd, 3rd and 4th in reference to the lowest quartile (Ptrend=0.024). The association with all-cause mortality examined as a secondary outcome was slightly stronger (hazard ratio of 4th quartile: 1.97 [1.15-3.36]; Ptrend=0.017).


In patients with stable coronary heart disease, serum gamma-GT was associated with prognosis independent of a variety of established risk markers. The association appeared similar to that reported for primary cardiovascular disease, which should motivate additional studies of its clinical utility in cardiovascular patient care.

[Indexed for MEDLINE]

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