Advertisement

Serum gamma-glutamyl transferase activity: A new marker for stent restenosis?

      Abstract

      Stent restenosis remains the main limitation of percutaneous coronary intervention. Elevated serum gamma-glutamyl transferase (GGT) level is associated with an inflammatory response. We aimed to determine the correlation of stent restenosis with the serums level of GGT. One hundred and twenty patients (age 58.56 ± 10.46 years, 66% male) with a history of coronary stent implantation and had undergone control coronary angiography (60 with restenosis and 60 without) were included. All had baseline serum GGT activity and were free of systemic and hepatobiliary disease. Median baseline serum GGT activity was significantly higher in patients with restenosis (34.00 U/L (24.00–47.75)) than in those without restenosis (21.00 U/L (17.25–26.7500)) (P < 0.0001). Stent restenosis was identified in 38% of the patients with a serum GGT value >40 U/L and in 5% of patients with a serum GGT value ≤40 U/L (P < 0.001). Serum C-reactive protein (CRP) and total bilirubin levels were significantly higher (P = 0.011 and 0.037, respectively) and alkaline phosphatase levels were significantly lower in patients with restenosis (P = 0.029). Levels of GGT, CRP, and alkaline phosphatase were independent predictors of restenosis (P = 0.001, 0.019 and 0.004, respectively). In conclusion, the serum level of GGT may be an independent marker for stent restenosis.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Atherosclerosis
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Radke P.W.
        • Kaiser A.
        • Frost C.
        • Sigwart U.
        Outcome after treatment of coronary in-stent restenosis; results from a systematic review using meta-analysis techniques.
        Eur Heart J. 2003; 24: 266-273
        • Toutouzas K.
        • Colombo A.
        • Stefanadis C.
        Inflammation and restenosis after percutaneous coronary interventions.
        Eur Heart J. 2004; 25: 1679-1687
        • Rahman I.
        • MacNee W.
        Oxidative stress and regulation of glutathione in lung inflammation.
        Eur Respir J. 2000; 16: 534-554
        • Kugelman A.
        • Choy H.A.
        • Liu R.
        • et al.
        Gamma-glutamyl transpeptidase is increased by oxidative stress in rat alveolar L2 epithelial cells.
        Am J Respir Cell Mol Biol. 1994; 11: 586-592
        • Lee D.H.
        • Ha M.H.
        • Kim J.H.
        • et al.
        Gamma-glutamyltransferase and diabetes—a 4 year follow-up study.
        Diabetologia. 2003; 46: 359-364
        • Paolicchi A.
        • Minotti G.
        • Tonarelli P.
        • et al.
        Gamma-glutamyl transpeptidase-dependent iron reduction and LDL oxidation—a potential mechanism in atherosclerosis.
        J Investig Med. 1999; 47: 151-160
        • Drozdz R.
        • Parmentier C.
        • Hachad H.
        • et al.
        Gamma-glutamyl transferase dependent generation of reactive oxygen species from a glutathione/transferrin system.
        Free Radic Biol Med. 1998; 25: 786-792
        • Pleiner J.
        • Mittermayer F.
        • Schaller G.
        • et al.
        Inflammation-induced vasoconstrictor hyporeactivity is caused by oxidative stress.
        J Am Coll Cardiol. 2003; 42: 1656-1662
        • Rollason J.G.
        • Pincherle G.
        • Robinson D.
        Serum gamma glutamyl transpeptidase in relation to alcohol consumption.
        Clin Chim Acta. 1972; 39: 75-80
        • Lee D.H.
        • Jacobs Jr., D.R.
        • Gross M.
        • et al.
        Gamma-glutamyltransferase is a predictor of incident diabetes and hypertension: the coronary artery risk development in young adults (CARDIA) study.
        Clin Chem. 2003; 49: 1358-1366
        • Emdin M.
        • Passino C.
        • Michelassi C.
        • et al.
        Prognostic value of serum gamma-glutamyl transferase activity after myocardial infarction.
        Eur Heart J. 2001; 22: 1802-1807
        • Wannamethee G.
        • Ebrahim S.
        • Shaper A.G.
        Gamma-glutamyltransferase: determinants and association with mortality from ischemic heart disease and all causes.
        Am J Epidemiol. 1995; 142: 699-708
        • Gaspardone A.
        • Crea F.
        • Versaci F.
        • et al.
        Predictive value of C-reactive protein after successful coronary-artery stenting in patients with stable angina.
        Am J Cardiol. 1998; 82: 515-518
        • Persijn J.P.
        • van der Slik W.
        A new method for the determination of gamma glutamyltransferase in serum.
        J Clin Chem Clin Biochem. 1976; 14: 421-427
        • Versaci F.
        • Gaspardone A.
        Prevention of restenosis after stenting: the emerging role of inflammation.
        Coron Artery Dis. 2004; 15: 307-311
        • Kornowski R.
        • Hong M.K.
        • Tio F.O.
        • et al.
        In-stent restenosis: contributions of inflammatory responses and arterial injury to neointimal hyperplasia.
        J Am Coll Cardiol. 1998; 31: 224-230
        • Takahashi Y.
        • Oakes S.M.
        • Williams M.C.
        • et al.
        Nitrogen dioxide exposure activates gamma-glutamyl transferase gene expression in rat lung.
        Toxicol Appl Pharmacol. 1997; 143: 388-396
        • Karp D.R.
        • Shimooku K.
        • Lipsky P.E.
        Expression of gamma-glutamyl transpeptidase protects ramos B cells from oxidation-induced cell death.
        J Biol Chem. 2001; 276: 3798-3804
        • Ross R.
        Mechanism of disease: atherosclerosis—an inflammatory disease.
        N Engl J Med. 1999; 340: 115-126
        • Lee R.T.
        • Libby P.
        The unstable atheroma.
        Arterioscler Thromb Vasc Biol. 1997; 17: 1859-1867
        • Berliner J.A.
        • Heinecke J.W.
        The role of oxidized lipoproteins in atherogenesis.
        Free Rad Biol Med. 1996; 20: 707-727
        • Stark A.A.
        Oxidative metabolism of glutathione by gamma-glutamyl transpeptidase and peroxisome proliferation: the relevance to hepatocarcinogenesis. A hypothesis.
        Mutagenesis. 1991; 6: 241-245
        • Stark A.A.
        • Russell J.J.
        • Langenbach R.
        • et al.
        Localization of oxidative damage by a glutathione-gamma-glutamyl transpeptidase system in preneoplastic lesions in sections of livers from carcinogen-treated rats.
        Carcinogenesis. 1994; 15: 343-348
        • Paolicchi A.
        • Tongiani R.
        • Tonarelli P.
        • Comporti M.
        • Pompella A.
        gamma-glutamyl transpeptidase-dependent lipid peroxidation in isolated hepatocytes and HepG2 hepatoma cells.
        Free Radic Biol Med. 1997; 22: 853-860
        • Gulesserian T.
        • Wenzel C.
        • Endler G.
        • et al.
        Clinical restenosis after coronary stent implantation is associated with the heme oxygenase-1 gene promoter polymorphism and the heme oxygenase-1 +99G/C variant.
        Clin Chem. 2005; 51: 1661-1665
        • Niroomand F.
        • Hauer O.
        • Tiefenbacher C.P.
        • Katus H.A.
        • Kuebler W.
        Influence of alcohol consumption on restenosis rate after percutaneous transluminal coronary angioplasty and stent implantation.
        Heart. 2004; 90: 1189-1193