Gamma-glutamyltransferase as a cardiovascular risk factor

Abstract

The association of a novel factor with clinical vascular disease must meet the same high standard met by ‘traditional’ risk factors. Serum gamma-glutamyltransferase (GGT) activity is a low-cost, highly sensitive laboratory test: though it is currently considered as an index of hepato-biliary dysfunction and alcohol abuse,1 pathology studies from our group since 1998 have indicated its possible role in the pathogenesis of atherosclerosis.2,3 Furthermore, epidemiology studies on a total of 218 561 subjects from unselected populations4–6 or cohorts with ascertained disease7 have proven the role of GGT not only in predicting mortality from all causes, but also the clinical evolution of cardiac and cerebrovascular diseases towards life-threatening events, such as myocardial infarction, stroke, and cardiac death, independently from the occurrence of hepatic disease, alcohol consumption, and established traditional risk factors in multivariable analyses. As for what specifically concerns the occurrence of coronary events, first observations by Wannamethee et al .4 in British middle-aged men were confirmed in 2001 in this Journal by us for patients with angiographically established coronary artery disease (CAD).7 Serum GGT was associated with an increasing risk of cardiac death and non-fatal infarction for activity values within reference limits with a graded response relationship … *Corresponding author. Tel: +39 050 3152189; fax: +39 050 3152109. E-mail address : emdin{at}ifc.cnr.it