Gamma‐glutamyl transferase to albumin ratio as a novel predictor of bleeding events and mortality in patients after percutaneous coronary intervention: A retrospective cohort study

Abstract Objectives To determine whether gamma‐glutamyl transferase ( GGT) to albumin ratio (GAR) independently predicts mortality and bleeding events in coronary artery disease (CAD) patients who undergo percutaneous coronary intervention (PCI). Background Serum GGT and albumin levels have been associated with CAD risk and mortality. However, more analysis is needed to determine their predictive relationship with adverse outcomes. Methods In total, 5,638 patients from a large retrospective cohort study were enrolled from January 2008 to December 2016 and divided into two groups (GAR <0.62, n = 2,712 and GAR ≥0.62, n = 2,926). The average follow‐up time was 35.9 ± 22.6 months. Multivariate Cox regression analyses were performed to determine the risk of all‐cause mortality and bleeding events associated with GAR. Results The low‐GAR group had a significantly higher number of all‐cause mortality ( p = .016) and bleeding events ( p = .010) than the high‐GAR group. Multivariate Cox regression analyses showed that the risk of all‐cause death and bleeding events decreased by 23.8% (hazard risk [HR] = 0.762 95% confidence interval [CI]: 0.601–0.966, p = .025) and 39.4% (HR = 00.616, 95% CI: 0.446–0.852, p = .003), respectively, in the high‐GAR group. In patients with acute coronary syndrome, the risk of bleeding events decreased by 57.3% in the high‐GAR group (HR = 0.427, 95% CI: 0.234–0.781, p = .006). In patients with stable coronary heart disease, the risk of all‐cause death decreased 28.6% (HR = 0.714, 95% CI: 0.540–0.944, p = .018) in the high‐GAR group. Conclusion GAR was an independent and novel predictor of mortality and bleeding events in CAD patients who underwent PCI.