Abstract
SERUM GAMMA GLUTAMYL TRANSFERASE (GGT) LEVEL IN NON-ST ELEVATION ACUTE CORONARY SYNDROME (NSTE-ACS) AND ITS CORRELATION WITH ANGIOGRAPHIC SEVERITY AND CARDIAC EVENTS

Chandramohan Anbalagan*, V. E. Dhandapani and M. Vengatesh

ABSTRACT

Background: GGT has shown to be involved in the development of cardiovascular disease. It is considered to play a central role in the formation of the fibrous cap, apoptosis of cellular elements of the lesion, plaque erosion and rupture, enhanced platelet aggregation and thrombosis leading to myocardial damage. The progress and prognosis of cardiovascular disease may be predicted by increasing GGT levels, a tool preferable to other biochemical indicators. Objective: To study the relationship between serum gamma glutamyl transferase (GGT) level in non-ST Elevation Acute Coronary Syndrome (NSTE-ACS) and its correlation with Angiographic severity and cardiac events. Materials and Methods: A total of 108 Non-ST Elevation Acute Coronary Syndrome patients were enrolled in this prospective cohort study. Patients whomever got admitted and fulfilled the inclusion/exclusion criteria were evaluated by history, physical examination, Complete Blood investigations including Serum Gamma Glutamyl Transferase level, Chest X-ray, electrocardiogram, echocardiography, coronary angiography at the time of admission. Gensini score was used to calculate the severity of angiographic lesions. Non-ST Elevation Acute Coronary Syndrome and its Angiographic severity and cardiac events was studied in three groups -NSTE-ACS patients with Significant Stenosis, NSTE-ACS patients with non-significant stenosis and the control group. Result: Out of 108 patients, 33 were females and 75 were males.72% patients had NSTE-ACS with significant angiographic stenosis, while 28% patients had NSTE-ACS with non-significant angiographic stenosis. In control group, 16 were females and 29 were males. The mean age of study cohort was 52.17 years with age ranging from 31 to 70 years. The mean age of the control group was 53.06 years with age ranging from 31 to 70 years. Age group of patients with NSTE- ACS and that of the control group were comparable. Patients with Non-ST Elevation Acute Coronary Syndrome showed significantly higher serum GTT level (33.12 U/l), in comparison to Control group (15.3 U/l) P Value 0.0045. Similarly, GGT level were significantly elevated in patients of ACS with significant angiographic stenosis (38.34 U/l ) in comparison to patient of ACS with insignificant angiographic stenosis (19.5 U/l) P value 0.001.Higher GGT levels were associated with triple vessel disease (43.5 U/l),Double vessel disease (41.1 U/l),and in Single Vessel Disease (33.91 U/l) P value < 0.0001. High GGT level also corresponds with high Gensini score P value <0.002 corelating with angiographic severity. Mean GGT values above 43 U/l were associated with adverse cardiac events. P value was insignificant 0.81. Conclusion: Serum gamma glutamyl transferase (GGT) levels are higher in patients with non-ST Elevation Acute Coronary Syndrome (NSTE-ACS). Higher GGT levels in NSTE-ACS patients are also associated with complex coronary anatomy, high Gensini score and adverse cardiac events.

Keywords: Non-ST Elevation- Acute coronary syndrome, Gensini Score, Serum Gamma Glutamyl Transferase.


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