Serum neutrophil gelatinase-associated lipocalin the estimation of hospital prognosis in patients with ST-elevated myocardial infarction

Abstract

We aimed to assess the clinical significance of serum levels of neutrophil gelatinase-associated lipocalin (sNGAL) for predicting in-hospital outcomes in patients with ST-elevated myocardial infarction (STEMI). Patients admitted within 24 hours of developing STEMI clinical symptoms were evaluated for sNGAL on hospitalization days 1 and 12. Recurrent myocardial infarction, early post-infarction angina, acute cerebrovascular accident, and death were assessed as adverse outcomes during hospitalization. The actors associated with adverse outcome were evaluated using univariate and multivariate regression analysis. Among the 260 STEMI patients included, 32% had ≥1 adverse in-hospital outcome, and significantly higher sNGAL on day 12, (but not on day 1) compared to sNGAL in patients with favorable outcome (p = 0.033). Type-2 diabetes mellitus, age > 60 years, reduced glomerular filtration rate during hospitalization, and high sNGAL on day 12 were identified as risk factors for adverse in-hospital outcome, associated with a 14% increase for each 1-year increment in age after 60 years, and a dramatic increase (3.2 times) for high sNGAL on day 12, with sNGAL ≥ 1.046 ng/ml indicating complicated hospitalization course. sNGAL concentration on the 12th day was associated with the existing adverse outcomes, acting as a marker of MI severity.

Neutrophil degranulation and myocardial infarction

“…The ROC curve analysis showed that NGAL of more than 190 ng/mL could detect cardiovascular mortality in STMI patients with a sensitivity of 86% and specificity of 77% [ 86 ]. Among 260 STEMI patients admitted within 24 h after onsetting clinical symptoms, plasm NGAL on day 12 could predict combined adverse outcomes, including recurrent myocardial infarction, post-infarction angina, acute cerebrovascular accident, and death [ 87 ]. In another study that included 357 consecutive patients admitted to the hospital within 24 h after onseting STEMI, plasm NGAL level of more than 1.25 ng/mL on the 12th–14th day was associated with a 2.9-fold higher risk of a combined endpoint of cardiovascular death or any cardiovascular complication after 3 years of follow-up [ 88 ].…”

“…Plasm NGAL on day 12 could predict combined adverse outcomes 2. A marker of MI severity [ 87 ] STEMI patients Plasm NGAL level of more than 1.25 ng/mL on the 12th–14th day was associated with a higher risk of a combined endpoint of cardiovascular death or any cardiovascular complication [ 88 ] ACS patients NGAL concentration could predict long-term mortality [ 89 ] STEMI patients Plasm NGAL level above 2.6 ng/ml on day 12 after onsetting STEMI was related to a fourfold increase of all-cause mortality [ 90 ] STEMI patients STEMI patients in the higher NGAL group presented greater risk of MACEs and all-cause mortality [ 91 ] Cathelicidin diagnostic value Patients or MI mice 1. CRAMP was reduced from I/R mice and oxygen glucose treated cardiomyocytes 2.…”

Plasma neutrophil gelatinase-associated lipocalin and risk of cardiovascular disease: Findings from the PREVEND prospective cohort study

“…[15][16][17] A number of studies have also reported associations between elevated NGAL levels and poor outcomes (e.g., mortality, hospital readmissions, heart failure, major adverse cardiac events) in patients with pre-existing CVD or kidney disease. [18][19][20][21][22][23] The overall evidence suggests that NGAL may be involved in CVD development.…”

Prognostic value of neutrophil gelatinase-associated lipocalin and glycosylated hemoglobin for non-ST-segment elevation myocardial infarction patients with single concomitant chronic total occlusion following primary percutaneous coronary intervention

“…[24] The prognostic value of NGAL level at discharge, as an indicator to complement assessments of brain natriuretic peptide, is a strong prognostic indicator of 30 days outcomes in patients admitted for acute heart failure. [13] Barbarash et al [25] and Karetnikova et al [26] found measurement of NGAL level in patients with STEMI on the 12th to 14th day after hospital admission may improve prediction of MI severity and adverse cardiovascular events. A study from Russia found NGAL level above 2.6 ng/mL on 12th day during hospital stay lead to 4 times all-cause mortality during 3-year follow-up.…”