Serum γ-Glutamyl Transferase and Risk of Heart Failure in the Community

Objective-To examine the association of serum gamma-glutamyltransferase (GGT) with incident heart failure. Methods and Results-We related serum GGT to the incidence of heart failure in 3544 (mean age, 44.5 years; 1833 women and 1711 men) Framingham Study participants who were free of heart failure and myocardial infarction. On follow-up (mean, 23.6 years), 188 participants (77 women) developed new-onset heart failure. In multivariable Cox proportional hazards regression models adjusting for standard risk factors and alcohol consumption as time-varying covariates (updated every 4 years), each SD increase in log-GGT was associated with a 1.39-fold risk of heart failure (95% CI, 1.20 to 1.62). The linearity of the association was confirmed by multivariable-adjusted splines, and the relations remained robust on additional adjustment for hepatic aminotransferases and C-reactive protein. Participants with a serum GGT level at the median or greater had a 1.71-fold risk of heart failure (95% CI, 1.21 to 2.41) compared with individuals with GGT concentrations less than the median. GGT marginally increased the model C-statistic from 0.85 to 0.86 but improved the risk reclassification modestly (net reclassification index, 5.7%; P = 0.01). Conclusion-In this prospective study of a large community-based sample, higher serum GGT concentrations within the normal range were associated with greater risk of heart failure and incrementally improved prediction of heart failure risk. (Arterioscler Thromb Vasc Biol. 2010;30:1855-1860.)