Prognostic role of serum gamma-glutamyl transferase levels in patients with pulmonary thromboembolism

Gamma-glutamyl transferase (GGT) is one of the most important markers of oxidative stress. Serum GGT activity is an independent risk factor for myocardial infarction and cardiac death in patients with coronary artery disease. Serum GGT has not previously been elucidated in the pulmonary thromboembolism (PTE). The study included 163 patients and spiral chest pulmonary angiography were the most used to confirm acute PE (98%). On admission serum GGT (reference value, 5-61 mg/dL) was measured. Receiver operating characteristic analysis was performed to determine the GGT cut-off levels with regard to prognosis. The patients with hepatic disease and alchol abuse were excluded from the study. The median age was 72 years, and 106 (65%) were females. All-cause in hospital mortality 14.1% and 30-day mortality was 16.6%. Median GGT levels in patients who 30-day died than in surviving patients was higher (48 mg/dL vs 32 mg/dL, p= 0.01). Serum GGT values≤26 show high negative predictive values for all-cause mortality (91%). In univariate analysis, a cut-off level of GGT>26 mg/dL for 30-day mortality were OR: 3.1 (95% CI: 1.2–7.9). The present study suggests that serum GGT level appears to be risk stratification patients with PTE. The results should be confirmed with other randomized prospective studies.