목적 : 혈청 감마-글루타밀 트랜스퍼라제(GGT)는 관상동맥 죽상경화반 내의 저밀도 지단백(LDL)의 산화과정을 촉매 하여 관상동맥 질환의 진행에 관여하며, 관상동맥 질환의 과거력이 있는 환자에서 심장사와 재경색의 독립적인 예후 예측인자로 알려져 있다. 저자는 관상동맥 질환의 과거력이 없는 급성 관상동맥 증후군 환자에서 예후 예측인자로서의 혈청 GGT의 효용성을 연구 하였다. 방법 : 흉통을 주소로 응급실을 방문하여 급성 심근경색으로 진단받은 환자의 혈청 GGT 값을 측정하여 응급실 방문당시 혈청 GGT 값이 정상범위(남자 : 8-61 U/L; 여자 : 5-31 U/L)에 있었던 192명(남/여=143/49, 평균 연령 : 60.8±11.8세)의 환자를 대상으로 하여, 추적 기간(16.5±10.8개월) 내 심장사건이 재발한 환자에서의 혈청 GGT 값을 심장사건이 없었던 환자의 혈청 GGT 값과 비교 하였다. 결과 : 급성 심근경색 환자 192명중 추적 기간 내 17명의 환자에서 심장사와 재경색이 있었으며, 23명의 환자에서 불안정협심증이 있었다. 이 환자들의 혈청 GGT값을 심장사건이 없었던 환자의 혈청 GGT 값과 비교하였을 때 통계적으로 유의한 차이를 보였다(29.5±10.0 U/L 대 25.0±11.2 U/L p=0.024). 그러나 다변량 분석에서 혈청 GGT에 영향을 줄 수 있는 혼란변수들과 알려진 심혈관계 질환의 위험인자로 보정하였을 경우 독립적인 예후 예측인자가 되지 못했다. 결론 : 심질환의 과거력이 없는 심근경색 환자의 예후 예측인자로 심근경색의 급성기에 측정한 혈청 GGT값은 통계적으로 유의한 차이는 있으나, 독립적인 예후 예측인자가 되지 못했다.

Background : Serum gamma-glutamyl transferase activity (GGT) is able to catalyse low-density lipoprotein oxidation in coronary atherosclerotic plaques and has a role in the pathogenesis of atherosclerosis. GGT has been shown to be an independent risk factor for cardiac mortality in patients with a previous myocardial infarction. The purpose of this study is to determine the prognostic value of GGT within its normal range at an acute stage in patients with acute myocardial infarction. Methods : In a retrospective study, GGT and other cardiac risk factors were evaluated in 192 patients (M/F=143/49; mean age: 60.8±11.8 years) who were diagnosed with an acute myocardial infarction at the emergency room. We compared the serum GGT values for each patient with or without a cardiac event, including cardiac death, non-fetal myocardial infarction and unstable angina, after an acute myocardial infarction for a mean follow-up of 16.5±10.8 months. Results : During the follow-up period, 17 patients underwent cardiac death and experienced an acute myocardial infarction and 23 patients had unstable angina. Although the mean GGT values were significantly different from patients with cardiac events (29.5±10.0 U/L vs 25.0±11.2 U/L, p=0.024), serum GGT was not an independent cardiac risk factor for a cardiac event based on multivariate analysis adjusted for age, sex, alcohol and known cardiovascular risk factors. Conclusions : Serum GGT within its normal range at an acute stage in patients that experienced an acute myocardial infarction is not an independent prognostic marker.(Korean J Med 72:281-289, 2007)

Background : Serum gamma-glutamyl transferase activity (GGT) is able to catalyse low-density lipoprotein oxidation in coronary atherosclerotic plaques and has a role in the pathogenesis of atherosclerosis. GGT has been shown to be an independent risk factor for cardiac mortality in patients with a previous myocardial infarction. The purpose of this study is to determine the prognostic value of GGT within its normal range at an acute stage in patients with acute myocardial infarction. Methods : In a retrospective study, GGT and other cardiac risk factors were evaluated in 192 patients (M/F=143/49; mean age: 60.8±11.8 years) who were diagnosed with an acute myocardial infarction at the emergency room. We compared the serum GGT values for each patient with or without a cardiac event, including cardiac death, non-fetal myocardial infarction and unstable angina, after an acute myocardial infarction for a mean follow-up of 16.5±10.8 months. Results : During the follow-up period, 17 patients underwent cardiac death and experienced an acute myocardial infarction and 23 patients had unstable angina. Although the mean GGT values were significantly different from patients with cardiac events (29.5±10.0 U/L vs 25.0±11.2 U/L, p=0.024), serum GGT was not an independent cardiac risk factor for a cardiac event based on multivariate analysis adjusted for age, sex, alcohol and known cardiovascular risk factors. Conclusions : Serum GGT within its normal range at an acute stage in patients that experienced an acute myocardial infarction is not an independent prognostic marker.(Korean J Med 72:281-289, 2007)

Gamma-glutamyl transferase, Risk factors, Acute myocardial infarction