Prognostic Significance of Neutrophil Gelatinase–Associated Lipocalin in ST-Segment Elevation Myocardial Infarction

Akçay, Adnan Burak; Özlü, Mehmet Fatih; Şen, Nihat; Çay, Serkan; Öztürk, Oktay Hasan; Yalıcn, Fatih; Bilen, P.; Kanat, Selçuk; Karakaş, Mehmet; İşleyen, Ahmet; Demir, Ahmet Duran; Söğüt, Sadık; Covic, Adrian; Kanbay, Mehmet

doi:10.2310/jim.0b013e31823e9d86

Cited by 30 publications

(39 citation statements)

References 32 publications

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“…The median (interquartile range) time from ICU arrival to collection of the first samples was 16 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) hours. At least 3 months of follow-up data were available for 639 (92.3%) patients, and full 9-month outcome was known for 552 (79.8% of the initial cohort) patients, with 217 (39.3% of those with complete follow-up) patients meeting the primary end point of death or dialysis.…”

Section: Resultsmentioning

confidence: 99%

Tissue Inhibitor Metalloproteinase-2 (TIMP-2)⋅IGF-Binding Protein-7 (IGFBP7) Levels Are Associated with Adverse Long-Term Outcomes in Patients with AKI

Koyner

Shaw

Chawla³

et al. 2015

Journal of the American Society of Nephrology

209

142

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Tissue inhibitor metalloproteinase-2 (TIMP-2) and IGF-binding protein-7 (IGFBP7) have been validated for risk stratification in AKI. However, the association of urinary TIMP-2 and IGFBP7 with longterm outcomes is unknown. We evaluated the 9-month incidence of a composite end point of all-cause mortality or the need for RRT in a secondary analysis of a prospective observational international study of critically ill adults. Two predefined [TIMP-2]z[IGFBP7] cutoffs (0.3 for high sensitivity and 2.0 for high specificity) for the development of AKI were evaluated. Cox proportional hazards models were used to determine risk for the composite end point. Baseline

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Section: Resultsmentioning

confidence: 99%

Tissue Inhibitor Metalloproteinase-2 (TIMP-2)⋅IGF-Binding Protein-7 (IGFBP7) Levels Are Associated with Adverse Long-Term Outcomes in Patients with AKI

Koyner

Shaw

Chawla³

et al. 2015

Journal of the American Society of Nephrology

209

142

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“…There are several studies which use NGAL for risk stratification in patients with unstable angina (UA) [9] and acute myocardial infarction (AMI) [10,11], but its role in patients with stable angina was not established. Furthermore, most of the studies concentrate on short-term outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…They found that high plasma NGAL concentration measured 30 minutes before PCI independently predicts all-cause mortality and major adverse cardiovascular events (MACE) after STEMI on a 2-year follow-up. In another recent study investigators demonstrated that high NGAL concentration is a predictor of in-hospital and 1-year mortality and MACE in patients with STEMI [11]. …”

Section: Discussionmentioning

confidence: 99%

Does Neutrophil Gelatinase-Asociated Lipocalin Have Prognostic Value in Patients with Stable Angina Undergoing Elective PCI? A 3-Year Follow-Up Study

Bachórzewska−Gajewska

Tomaszuk‐Kazberuk

Jarocka

et al. 2013

Kidney Blood Press Res

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Background: Neutrophil gelatinase-associated lipocalin (NGAL), a widely accepted diagnostic marker of acute renal injury (AKI) may be involved in the development of atherosclerosis. Purpose: To assess the prognostic significance of serum and urinary NGAL and serum cystatin C in patients with stable angina undergoing percutaneous coronary intervention (PCI) on a 3-year follow-up. Methods: We included patients with stable angina undergoing PCI. Serum NGAL and cystatin C were evaluated before and 4h, 8h after PCI. Urinary NGAL was evaluated before and 12h and 24h after the procedure. The primary end-point was all-cause mortality on a 3-year follow-up. Results: Among 132 patients there were 63% of males (mean age 64,5±9,8 years). Mean eGFR was 86.2±28.5 ml/min. During follow-up 8% of the patients died. All-cause mortality was significantly higher in patients with increased urinary NGAL concentration 12h after PCI (p=0.04). Urinary NGAL 12h after PCI correlated with eGFR (p<0.05), with serum NGAL evaluated before and 4h and 8h after PCI (p<0.05) and with increased serum cystatin C evaluated 4 hours after PCI (p<0.05). Conclusions: Increased urinary NGAL concentration is a strong predictor of mortality in patients with stable angina who undergo PCI and may be used for the risk stratification in this population.

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“…Recent studies suggest that NGAL is a strong marker of outcome in patients with acute myocardial infarction and HF. 31,32 We have also shown this in 584 patients with ST-segmentelevation myocardial infarction.…”

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confidence: 93%

Plasma Neutrophil Gelatinase-Associated Lipocalinin in the General Population

Lindberg

Jensen

Møgelvang

et al. 2014

ATVB

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Objective— Neutrophil gelatinase-associated lipocalin (NGAL) is a glycoprotein stored in granules of neutrophil leukocytes participating in inflammatory and atherosclerotic processes and possibly plaque rupture. Despite the putative role of NGAL in atherosclerosis and acute myocardial infarction, human studies of plasma NGAL are still limited. Approach and Results— We prospectively followed 5599 randomly selected men and women from the community in the fourth Copenhagen Heart Study. Plasma NGAL was measured at study entry. Participants were followed for 10 years. During follow-up, 20% died (n=1120) and 15% (n=884) developed a major adverse cardiovascular event. Plasma NGAL associated strongly with all inflammatory markers (high-sensitivity C-reactive protein, total leukocyte count, neutrophil count) and inversely with estimated glomerular filtration rate (all, P <0.001). Multivariate analysis identified neutrophil leukocyte count as the main determinant of plasma NGAL. During follow-up, participants with increasing NGAL had increased risk of all-cause mortality and major adverse cardiovascular event (both, P <0.001). Even after adjustment for confounding risk factors by Cox regression analysis, NGAL remained an independent predictor of both all-cause mortality and major adverse cardiovascular event. When added to the Framingham risk score, NGAL improved c -statistics and correctly reclassified ≈15% into more appropriate risk groups. In comparison with high-sensitivity C-reactive protein, when both markers were added to the Framingham risk score, NGAL conferred 3× to 4× the risk. Conclusions— Plasma NGAL is strongly associated with inflammation in the general population. NGAL independently associated with 10-year outcome, and when added to the Framingham risk score, NGAL both improves c -statistics and correctly reclassifies participants into more accurate risk categories.

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Prognostic Significance of Neutrophil Gelatinase–Associated Lipocalin in ST-Segment Elevation Myocardial Infarction

Abstract: High NGAL levels may be associated with poor prognosis after PCI in patients with STEMI. However, further studies with larger numbers of patients and longer follow-up are required to evaluate the usefulness of plasma NGAL level for predicting prognosis of STEMI.

Cited by 30 publications

References 32 publications

Tissue Inhibitor Metalloproteinase-2 (TIMP-2)⋅IGF-Binding Protein-7 (IGFBP7) Levels Are Associated with Adverse Long-Term Outcomes in Patients with AKI

Tissue Inhibitor Metalloproteinase-2 (TIMP-2)⋅IGF-Binding Protein-7 (IGFBP7) Levels Are Associated with Adverse Long-Term Outcomes in Patients with AKI

Does Neutrophil Gelatinase-Asociated Lipocalin Have Prognostic Value in Patients with Stable Angina Undergoing Elective PCI? A 3-Year Follow-Up Study

Plasma Neutrophil Gelatinase-Associated Lipocalinin in the General Population

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