Thromb Haemost 2019; 119(06): 1021-1030
DOI: 10.1055/s-0039-1681103
Atherosclerosis and Ischaemic Disease
Georg Thieme Verlag KG Stuttgart · New York

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

Ying-Ying Zheng
1  Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
2  Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
,
Ting-Ting Wu
2  Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
,
You Chen
2  Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
,
Xian-Geng Hou
2  Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
,
Yi Yang
2  Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
,
Xiang Ma
2  Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
,
Yi-Tong Ma
2  Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
,
Jin-Ying Zhang
1  Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
,
Xiang Xie
2  Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
› Author Affiliations
Funding This research was funded by the National Natural Science Foundation of China (U1603381, 81760043 and 81560070).
Further Information

Publication History

17 December 2018

25 January 2019

Publication Date:
01 March 2019 (eFirst)

Abstract

Background Gamma-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.

Methods A 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.

Results We 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.

Conclusion This study indicates that GPR is an independent and novel predictor of adverse long-term outcomes in CAD patients who underwent PCI.