γ-Glutamyl Transferase as a Risk Factor for All-Cause or Cardiovascular Disease Mortality Among 5912 Ischemic Stroke

Background and Purpose— The aim of the study was to evaluate the association of the measurement of serum γ-glutamyl transferase (GGT) concentrations at admission with 1-year all-cause or cardiovascular disease (CVD) mortality in patients with acute ischemic stroke. Methods— This prospective, multicenter cohort study was conducted in 4 stroke centers in China. Baseline GGT measurements were tested. The relationship of GGT to the risk of death from all-cause or CVD was examined among 1-year follow-up patients. Results— We recorded results from 5912 patients with stroke. In those patients, 51.0% were men, and the median age was 61 years. In both men and women, high GGT was significantly associated with total mortality from all-cause or CVD (P <0.001). The elevated GGT revealed adjusted hazard ratios (95% confidence interval) of 3.03 (1.99–4.54) and 3.24 (2.14–4.92) for mortality from all-cause and CVD, respectively. With an area under the curve of 0.69 (95% confidence interval, 0.66–0.73), GGT showed a significantly greater discriminatory ability to predict all-cause mortality as compared with others factors. GGT improved the National Institutes of Health Stroke Scale score (area under the curve of the combined model, 0.75 [95% confidence interval, 0.73–0.78];P <0.01).Conclusions— This study demonstrates that GGT is independently associated with all-cause and CVD mortality in patients with ischemic stroke.