Gamma-Glutamyl Transferase-to-Platelet Ratio as a Novel Predictor of Long-Term Adverse Outcomes in Patients after Undergoing Percutaneous Coronary Intervention: A Retrospective Cohort Study
Gamma-Glutamyl Transferase-to-Platelet Ratio as a Novel Predictor of Long-Term Adverse Outcomes in Patients after Undergoing Percutaneous Coronary Intervention: A Retrospective Cohort Study
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γ-谷氨酰转移酶与血小板比率作为接受经皮冠状动脉介入治疗后患者长期不良结果的新预测因子：一项回顾性队列研究
DOI：
10.1055/s-0039-1681103
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发表时间：
2019-06-01
影响因子：
6.7
通讯作者：
Xie, Xiang
中科院分区：
文献类型：
--
作者：
Zheng, Ying-Ying;Wu, Ting-Ting;Xie, Xiang
研究背景γ-谷氨酰转移酶（GGT）参与了冠心病（CAD）和肝病的发病机制，并且有报道称GGT/血小板比值（GPR）是肝纤维化和肝癌不良结局的独立预测因子。然而，GPR与冠心病患者经皮冠状动脉介入治疗（PCI）后不良结局之间的关系尚未研究。方法2008年1月至2016年12月，共有5，636例患者参加了PCI后冠心病患者的临床结局和危险因素的回顾性队列研究，根据GPR分为两组（GPR <0.12，n = 2，769; GPR ≥ 0.12，n = 2，867）。主要结局是PCI术后的长期死亡率，包括全因死亡率（ACM）和心源性死亡率（CM）。结果两组ACM（p= 0.011）、CM（p = 0.001）、主要不良心血管事件（MACEs，p< 0.024）、主要不良心脑血管事件（MACEs，p= 0.014）和出血事件（p= 0.003）的发生率有显著性差异。多因素考克斯回归分析显示，GPR是ACM的独立预测因子（风险比[HR]：1.536 [95%置信区间[CI]：1.162-2.032]，p= 0.003），CM（HR：1.763 [95% CI：1.283-2.424]，p< 0.001），MACCE（HR：1.269 [95% CI：1.066-1.511]，p= 0.007）和MACE（HR：1.308 [95% CI：1.089-1.570]，p= 0.004），但它仅是出血事件发生率的独立预测因子（HR：3.104 [95% CI：1.680-5.736]，p< 0.001）。
BackgroundGamma-glutamyl transferase (GGT) has been shown to be involved in the pathogenesis of both coronary artery disease (CAD) and liver disease, and it has been reported that the GGT-to-platelet ratio (GPR) is an independent predictor for adverse outcomes from liver fibrosis and hepatic carcinoma. However, the relation between the GPR and adverse outcomes in CAD patients after percutaneous coronary intervention (PCI) has not been investigated.MethodsA total of 5,636 patients enrolled in Clinical Outcomes and Risk Factors of Patients with Coronary Heart Disease after PCI, a retrospective cohort study, from January 2008 to December 2016, were divided into two groups according to GPR (GPR < 0.12,n= 2,769 and GPR ≥ 0.12,n= 2,867). The primary outcome was long-term mortality including all-cause mortality (ACM) and cardiac mortality (CM) after PCI. The average follow-up time was 35.9 ± 22.6 months.ResultsWe found that there were significant differences between the two groups in the incidences of ACM (p= 0.011), CM (p= 0.001), major adverse cardiovascular events (MACEs,p< 0.024), major adverse cardiovascular and cerebrovascular events (MACCEs,p= 0.014) and bleeding events (p= 0.003). Multivariate Cox regression analyses showed that GPR was an independent predictor for ACM (hazard ratio [HR]: 1.536 [95% confidence interval [CI]:1.162–2.032],p= 0.003), CM (HR: 1.763 [95% CI: 1.283–2.424],p< 0.001), MACCEs (HR: 1.269 [95% CI: 1.066–1.511],p= 0.007) and MACEs (HR: 1.308 [95% CI: 1.089–1.570],p= 0.004) in stable CAD patients but that it was an independent predictor for only the incidence of bleeding events (HR: 3.104 [95% CI: 1.680–5.736],p< 0.001) in acute coronary syndrome (ACS) patients.ConclusionThis study indicates that GPR is an independent and novel predictor of adverse long-term outcomes in CAD patients who underwent PCI.