Plasma neutrophil gelatinase-associated lipocalin levels in acute myocardial infarction and stable coronary artery disease

Şahinarslan, Asife; Kocaman, Sinan Altan; Baş, Duygu B.; Akyel, Ahmet; Erçin, Uğur; Zengin, Ozlem; Timurkaynak, Timur

doi:10.1097/mca.0b013e3283472a71

Cited by 70 publications

(38 citation statements)

References 27 publications

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“…It may also exist in a urinary dimeric form secreted by activated leukocytes in the setting of urinary tract infection [11]. Blood NGAL has been found to be elevated the setting of acute myocardial infarction to a greater extent than in patients with stable coronary artery disease [12,13]. We believe blood levels >200 ng/ml observed in our study reflect abnormal production of NGAL in the basal and post-contrast state.…”

Section: Discussionmentioning

confidence: 53%

Neutrophil Gelatinase-Associated Lipocalin: A Novel Marker of Contrast Nephropathy Risk

McCullough¹,

Williams²,

Stivers³

et al. 2012

Am J Nephrol

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Background: Neutrophil gelatinase-associated lipocalin (NGAL, siderocalin) is a protein secreted by the kidney in the setting of acute kidney injury in an attempt to regulate and bind the release of catalytic iron from injured cells. We sought to evaluate the relationships between baseline NGAL, renal filtration function, and the degree of injury reflected by further increases in NGAL. Methods: This study was a prospective, blinded assessment of blood samples taken from patients with estimated glomerular filtration rate (eGFR) <75 ml/min/1.73 m² undergoing non-urgent coronary angiography and intervention using iodinated contrast. Renal transplant recipients, dialysis patients, and administration of iodinated contrast in the prior 30 days were exclusion criteria. Plasma NGAL was measured using the Alere™ assay. Serum creatinine (Cr) was measured using calibrated methods at a core laboratory. Samples were obtained at baseline, 1, 2, 4, 6, 12, 24, and 48 h after contrast administration. Results: A total of 63 subjects were enrolled with a mean age of 69.4 ± 9.1 years, 73% male, 35% with diabetes, and a mean eGFR of 47.82 ± 15.46 ml/min/1.73 m². The correlation between eGFR and NGAL was r = –0.61, 95% CI –0.74 to –0.44, p < 0.001. When stratified by baseline NGAL tertile, the peak NGAL observed for each group occurred at 29.0 ± 22.2 h and there was a twofold increase in the mean and peak change in NGAL across the tertiles. NGAL began to rise 6 h after contrast exposure and followed a similar course to serum Cr and at 48 h the overall mean NGAL was still rising. Only 2 patients sustained a rise in Cr of >25% or ≥0.5 mg/dl. Multivariate regression revealed that baseline NGAL (p < 0.001) and not eGFR (p = 0.95) was independently associated with the NGAL value at 48 h. Conclusions: Baseline NGAL is strongly correlated with eGFR in patients with reduced renal filtration function undergoing coronary angiography. The magnitude of rise in NGAL is positively associated with the baseline value and is analogous to the time course of Cr in blood after contrast exposure. NGAL and not eGFR is an independent predictor of changes in the post-procedure NGAL. A baseline NGAL level is necessary for the interpretation of NGAL levels in the evaluation of acute kidney injury.

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Section: Discussionmentioning

confidence: 53%

Neutrophil Gelatinase-Associated Lipocalin: A Novel Marker of Contrast Nephropathy Risk

McCullough¹,

Williams²,

Stivers³

et al. 2012

Am J Nephrol

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“…In a recent study, increased NGAL levels were found to be an independent predictor of death and major adverse cardiac event outcomes in patients who received primary percutaneous coronary intervention for ST segment elevation myocardial infarction [26]. In addition, serum NGAL levels were found to be a useful predictor of the presence of CAD [32]. In this study, we describe for the first time the correlation of NGAL levels in patients with noncritical lesions.…”

Section: Discussionmentioning

confidence: 94%

Serum Neutrophil Gelatinase-Associated Lipocalin Levels and Aortic Stiffness in Noncritical Coronary Artery Disease

Soylu¹,

Nar²,

Aksan

et al. 2014

Cardiorenal Med

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Aim: The aim of this study was to establish the degree of aortic stiffness and levels of neutrophil gelatinase-associated lipocalin (NGAL) in patients with stable ischemic heart disease. Materials and Methods: Patients who were found to have stable, noncritical lesions on coronary angiography were included in the study [noncritical coronary artery disease (CAD)]. The control group consisted of those patients who had similar risk profiles and metabolic parameters without atherosclerosis on angiography. Results: A total of 101 patients were included in the study of which 56 had noncritical CAD. Whereas the aortic strain (9.11 ± 3.4 vs. 14.01 ± 4.1%, p < 0.001) and aortic distensibility (3.98 ± 1.9 10^-6 cm²/dyn vs. 6.33 ± 2.3 10^-6 cm²/dyn, p < 0.001) were lower in the noncritical CAD group, the aortic stiffness index was higher (6.34 ± 3.9 vs. 3.37 ± 2.4, p < 0.001) as compared to controls. Serum NGAL levels were higher in the noncritical CAD group (79.29 ± 38.8 vs. 48.05 ± 21.4 ng/ml, p < 0.001). NGAL levels were negatively correlated with aortic strain (p < 0.01, r = 0.57) and distensibility (p < 0.001, r = 0.62), but positively correlated with the aortic stiffness index (p < 0.001, r = 0.72). Conclusion: We show that in patients with noncritical CAD, the degree of aortic stiffness and NGAL levels are higher. These markers can be used as tools for further risk stratification of patients with noncritical CAD.

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“…Similarly in another study, serum NGAL levels showed an increasing tendency in CAD and AMI, although this was not significant. In the study by Arslan et al (38) that compared patients with stable CAD and AMI, significantly higher plasma NGAL Neutrophil Gelatinase-Associated Lipocalin and Pentraxin 3 in Acute Coronary Syndrome levels were detected in the AMI group; however, no difference was found between STEMI and NSTEMI. It was concluded that NGAL NGAL levels are more successful indicator in detecting MI than other inflammatory markers.…”

Section: Discussionmentioning

confidence: 97%

Diagnostic and Prognostic Significance of Neutrophil Gelatinase- Associated Lipocalin and Pentraxin-3 in Acute Coronary Syndrome

Özer¹,

Ergin²,

Kılınç³

et al. 2017

EAJEM

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Plasma neutrophil gelatinase-associated lipocalin levels in acute myocardial infarction and stable coronary artery disease

Abstract: The plasma level of NGAL is higher in patients with AMI compared with the patients with stable CAD. This finding may suggest an active pathophysiological role for NGAL in development of acute coronary events.

Cited by 70 publications

References 27 publications

Neutrophil Gelatinase-Associated Lipocalin: A Novel Marker of Contrast Nephropathy Risk

Neutrophil Gelatinase-Associated Lipocalin: A Novel Marker of Contrast Nephropathy Risk

Serum Neutrophil Gelatinase-Associated Lipocalin Levels and Aortic Stiffness in Noncritical Coronary Artery Disease

Diagnostic and Prognostic Significance of Neutrophil Gelatinase- Associated Lipocalin and Pentraxin-3 in Acute Coronary Syndrome

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