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Multicenter Study
. 2012 Jan;124(1-2):18-24.
doi: 10.1007/s00508-011-0046-4. Epub 2011 Sep 2.

Elevated γ-Glutamyltransferase in Implantable Cardioverter Defibrillator Patients

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Multicenter Study

Elevated γ-Glutamyltransferase in Implantable Cardioverter Defibrillator Patients

Wolfgang Dichtl et al. Wien Klin Wochenschr. .

Abstract

Background: Elevated γ-glutamyltransferase (GGT) is a new risk factor for cardiovascular diseases, but its impact on ventricular tachyarrhythmia occurrence and survival in patients with an implantable cardioverter defibrillator (ICD) is unknown.

Methods and results: Considering that GGT levels are gender-dependent, female ICD recipients were excluded from our database because of the low incidence of events. In a retrospective analysis, appropriate ICD therapy (both shocks and antitachycardia pacing due to ventricular tachyarrhythmias) occurred in 31.9% of 320 male patients who had received an ICD for primary prevention (median follow-up of 2.3 years), and in 55.1% of 423 male patients who had received an ICD for secondary prevention (median follow-up of 3.9 years). Compared to normal low GGT plasma levels (below 28 U/L), total mortality but not risk for appropriate ICD therapy was elevated for higher GGT categories (p for trend = 0.004 in primary prevention and p for trend = 0.002 in secondary prevention, respectively). In Cox regression analysis, elevated GGT (>56 U/L) remained an independent predictor of death both in primary (p = 0.011) and in secondary prevention (p = 0.006). Patients with elevated GGT and renal insufficiency defined by an estimated glomerular filtration rate <60 ml/min/1.73 m(2) suffered from excess total mortality jeopardizing the benefit of ICD therapy.

Conclusion: Elevation of GGT is an important adverse prognostic parameter in ICD patients. A possible role of GGT for improved patient selection for ICD therapy deserves further investigation.

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