The Association of Gamma-Glutamyl Transferase and Atrial Fibrillation

Background: Atrial fibrillation (AF) is the most commonly diagnosed cardiac arrhythmia in clinical practice and is related to significant morbidity and mortality. AF etiology and thus, predictive biomarkers are currently lacking. Liver enzymes have shown a correlation to cardiovascular disease. Gamma-glutamyl transferase (GGT) is a liver enzyme associated with oxidative stress that is postulated to have a link to AF occurrence. Researchers have recently placed emphasis on discovering a potential biomarker to predict AF. An elevation of systemic serum GGT and the association with the risk of AF development is the area of interest. Methods: Exhaustive search of available medical literature was performed using MEDLINE-Ovid, MEDLINE-Pubmed, Web of Science, Google Scholar, and UpToDate. Articles were determined relevant based on keywords and eligibility criteria. Results: Nine articles were reviewed and two were deemed relevant. Two observational studies were assessed for quality and critically reviewed. One study found that those in the highest quintile of GGT levels had a 40% increased risk of AF (HR 1.44, (95% CI 1.17-1.77). Another study found that there was a log-linear positive association of GGT with AF risk in analyses initially adjusted for age. Conclusion: The two studies both indicated an elevation in GGT and may be associated as a biomarker for the development of AF. Further study of this correlation is indicated before this biomarker can be implemented in clinical practice as a screening tool for AF.