Enzyme test may predict PCI contrast-induced nephropathy

Last Updated: 2015-07-07

By Reuters Staff

NEW YORK (Reuters Health) - In patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention (PCI), elevated levels of gamma-glutamyl transferase (GGT) may predict contrast-induced nephropathy (CIN), according to Turkish researchers.

In a June 4 online paper in the American Journal of Cardiology, Dr. Fatih Oksuz, of the Yuksek Ihtisas Education and Research Hospital, Ankara, and colleagues noted that there is evidence that GGT levels are associated with in-hospital adverse outcomes in these patients.

The researchers sought to determine whether this cardiovascular risk stratification biomarker might also be indicative of CIN risk.

The team analyzed data on 473 patients. They were divided into three groups according to GGT tertiles on admission. CIN was defined as a relative increase of at least 25% or an absolute increase of at least 0.5 mg/dL in creatinine concentrations within 72 hours after contrast exposure.

CIN incidence was significantly greater in the highest GGT tertile (29%) than in the other tertiles (both 11%). In-hospital deaths were also significantly greater in the highest tertile (5%) than in the middle (4%) and lowest tertile (1%).

Further analysis showed that a threshold value of GGT greater than 26.5 U/L had a 70% sensitivity and 60% specificity for CIN. Each 1 U/L increase in GGT was also associated with CIN risk (odds ratio 1.04). Among other significant variables were the presence of diabetes (OR 1.71) and contrast volume (OR 1.01 per 1 mL increase).

The investigators conceded that the number of subjects was small, and a longer period of follow-up is necessary to determine the long-term prognostic value of GGT level. They also lacked information on factors that may have influenced mortality and, "We did not evaluate patients for asymptomatic or unknown liver disease."

Nevertheless, they conclude that "GGT on admission was a significant and independent predictor of CIN."

Dr. Oksuz did not respond to a request for comment.

The authors reported no funding or disclosures.

SOURCE: http://bit.ly/1J2oL23

Am J Cardiol 2015.