Objectives

Sufficient coronary collateral circulation

(CCC) protects myocardial tissue against ischemia in

patients with coronary chronic total occlusion (CTO).

In this study, we aimed to investigate whether there

is an association between serum

c-glutamyl transferase

(GGT) levels and development of CCC in patients

with coronary CTO.

Materials and methods

A total of 203 patients with

CTO at coronary angiography were included in this study.

On the day of admission to the hospital, blood samples

were taken and GGT levels were analyzed for all patients.

Development of collateral circulation was graded according

to the Rentrop classification after coronary angiography.

Then, patients were divided into two groups on the basis

of CCC grades: group 1 included 99 patients (49%) with

poorly developed CCC, and group 2 included 104 patients

(51%) with well-developed CCC.

Results

Patients with poorly developed CCC had

significantly higher serum GGT levels compared with

those with well-developed CCC, (66.5±16 vs. 51.8±10 U/l,

P

< 0.0001). Correlation analysis showed an inverse

correlation between GGT levels and the Rentrope score

(

r = – 0.579, P < 0.001). Logistic regression analysis showed

that GGT level was an independent predictor of poorly

developed CCC (odds ratio 0.92, 95% confidence interval

0.90–0.94;

P < 0.001).

Conclusion

Increased serum GGT levels independently

predict poorly developed CCC in patients with coronary

CTO. Our results show that GGT is a simple and readily

available marker for sufficiency of CCC in patients with

CTO.