Role of Serum Gamma Glutamyl Transferase in Prediction of Coronary Artery Disease in the Young: A Cross sectional study in South India

BACKGROUND: Premature Coronary Artery Disease is an emerging Global burden of the century. Coronary Angiogram being a gold-standard invasive diagnostic procedure, its already overdue to identify a non-invasive predictive tool for risk stratification. In this study, we investigated the association of serum Gamma Glutamyl transferase and premature coronary artery disease (CAD) in patients undergoing coronary angiography in Government Stanley Medical College. METHODS: In this unicentric cross-sectional study, we enrolled male subjects aged ≤ 45 years and female subjects ≤ 55 years who underwent elective coronary angiography. Baseline characteristics and clinical history were recorded for all the participants. Serum levels of blood glucose, lipid profile and GGT were measured. Patients were divided into non-CAD and CAD groups based on angiography findings for comparisons and discriminations. RESULTS: From a total of 126 patients (age 42.0 ± 7 years, 77 males [61.1%] and 49 females [38.9%]), 74(58.7%) patients had premature CAD. A higher level of GGT [84.5 ± 34.2 in the CAD versus 37.3 ± 19.7 in the non-CAD group] was significantly associated with the presence of CAD (p < 0.001). The area under the receiver operating characteristic curve for GGT was 89.0% (range 83.2–94.9) and the sensitivity and specificity of GGT was 79.7% and 78.8%, respectively. Diagnostic accuracy of GGT was 79.4%. The positive predictive value and negative predictive value for GGT was 84.3 and 73.2, respectively. CONCLUSION: Based on our observations we would infer that serum GGT levels in patients with typical chest pain or positive non-invasive tests could predict the presence of premature CAD in young patients