Abstract 12730: The Impact of Admission Gamma-Glutamyltransferase Levels on the Development of Poor Myocardial Perfusion After Primary Percutaneous Intervention in Patients With Acute Myocardial Infarction
Aims: Increased oxidative stress in patients with acute myocardial infarction (MI) undergoing primary percutaneous coronary intervention (pPCI) may effect myocardial perfusion. Accordingly, this study was designed to investigate the impact of admission serum gamma-glutamyltransferase (GGT) levels on the development of poor myocardial perfusion after PCI in patients with acute MI.
Material and Methods: Study population consisted of 80 patients (64 men, mean age=67.5 ± 6.6 years), addmitted to our hospital with acute ST segment elevation MI undergoing pPCI. All patients underwent stenting following balloon angioplasty. Myocardial perfusion was evaluated by using TIMI myocardial perfusion grade (TMPG). Patients were divided into 2 groups according to TMPG after PCI. Group 1 consisted of 40 patients with TMPG 0–1 (30 men, mean age= 68.8 ± 5.3 years) and Group 2 comprised of 40 patients with TMPG 2–3 (34 men, mean age= 66.2 ± 7.5 years).
Results: Admission pain to balloon time, GGT and CK-MB levels of the patients in Group 1 were significantly higher than those of the patients in Group 2 (p<0.001; p<0.001; p=0.003, respectively). Univariate analysis identified pain to balloon time, serum GGT, proprecodural TIMI grade, left ventricular ejection fraction, wall motion score, age>70 years, Killip class, and number of Q waves as the predictors of poor myocardial perfusion. In multivariate logistic regression analysis, GGT levels and pain to balloon time were detected to have statistically significant independent association with poor myocardial perfusion. Adjusted odds ratios were calculated as 1.13 for GGT (p<0.001; CI=1.05–1.23) and 4.92 for pain to balloon time (p=0.001; CI=1.50–16.13).
Conclusions: On admission, high GGT levels in patients with acute MI undergoing pPCI is likely to be in the causal pathway leading to the development of poor myocardial perfusion, especially when combined with prolonged pain to balloon time
Keywords: Gamma-Glutamyltransferase Levels, Acute Myocardial Infarction, Myocardial Perfusion
- © 2010 by American Heart Association, Inc.