Effect of Serum γ-glutamyltranferase and Albumin Levels on the Response to Cardiac Resynchronization Therapy in the Elderly

Overview

Journal J Geriatr Cardiol

Specialty Geriatrics

Date 2020 Jul 17

PMID 32670361

Authors

Maciej Kubala

Alexis Hermida

Otilia Buiciuc

Pierre-Marc Lallemand

Genevieve Bertaina

Frederic Anselme

Didier Klug

Momar Diouf

Jean-Sylvain Hermida

Affiliations

Soon will be listed here.

Abstract

Background: Several liver function tests have been identified as predictors of hospitalization for heart failure (HF) and death in patients with chronic HF. The relationship between serum γ-glutamyltranferase (GGT) and albumin (SA) levels with the response to cardiac resynchronization therapy (CRT) has not been reliably determined. The aim of the study was to evaluate the impact of liver function tests on the results of CRT in the elderly.

Methods: Baseline GGT and SA were assessed before CRT device implantation in the elderly (> 70-year-old) patients. The endpoints were: (1) CRT response defined as > 5% left ventricular ejection fraction improvement and no hospitalization for HF or cardiovascular death; (2) hospitalizations; and (3) mortality.

Results: Eighty of 138 (58%) included patients were responders at nine months. Compared to responders, the SA levels were not significantly different (35.1 ± 5.4 33.6 ± 5.5 g/L, = 0.103); but the GGT levels, higher (81.6 ± 69.3 54.7 ± 49.6 U/L, = 0.013) in non-responders to CRT. GGT level was independently associated with non-response to CRT ( < 0.001, OR = 0.17; 95% CI: 0.08-0.38, < 0.001). GGT cut-off value ≥ 55 U/L was highly predictive of non-response [AUC = 0.65, 64% Sensitivity, 69% Specificity (95% CI: 0.56-0.74)]. GGT ≥ 55 U/L was also associated with higher risk of hospitalization for atrial fibrillation (AF) (95% 83%, = 0.024). Both SA and GGT had no impact on overall ( = 0.220, = 0.723) mortality.

Conclusions: Higher level of GGT is an independent predictor of non-response to CRT in patients over age 70 years and is associated with higher risk of hospitalization for AF. Baseline serum levels of albumin and GGT and have no impact on mortality in elderly patients undergoing CRT.

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