The Prognostic Utility of Plasma NGAL Levels in ST Segment Elevation in Myocardial Infarction Patients

Abstract

Introduction. Plasma neutrophil gelatinase-associated lipocalin (NGAL) levels in acute myocardial infarction (AMI) patients are markedly higher. In addition, plasma NGAL levels were increased in patients with acute and chronic heart failure as a complication of myocardial infarction. In this study, we investigated whether there is a difference between the prognostic use of plasma NGAL levels in ST-elevation myocardial infarction (STEMI) patients with preserved and reduced left ventricular ejection fraction (LVEF). Methods. 235 consecutive STEMI patients were enrolled in the study. Patients were divided into groups according to LVEF. Plasma NGAL, troponin I, creatine kinase MB (CKMB), and C-reactive protein (CRP) were measured. Finally, the study population examined with 34 reduced LVEF and 34 preserved LVEF consisted of a total of 68 patients (12 females; mean age, 61.5 ± 14.7). All patients were followed up prospectively for 6 months. This study group was divided into two subgroups as the patients who died (n = 14) and survived (n = 34), and plasma NGAL levels of the groups were compared. Results. The median of NGAL was 190.08 ng/ml. Age, troponin I, CKMB, CRP, glomerular filtration rate, and creatinine were higher in reduced LVEF groups. Plasma NGAL levels were also higher in reduced LVEF than in preserved LVEF, but statistically not significant (p=0.07). Plasma NGAL levels were significantly higher in death patients than in survived patients (p<0.001). In ROC curve analysis, the level to detect isolated cardiovascular mortality with a sensitivity of 86% and a specificity of 77% was 190 ng/mL for NGAL. Conclusion. Plasma NGAL levels can be used to predict cardiovascular mortality in STEMI patients.

Neutrophil degranulation and myocardial infarction

“…Plasma NGAL levels were markedly higher in death patients with STEMI than survivors. 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 ].…”

“…Plasma NGAL levels were markedly higher in death patients with STEMI than survivors 2. Plasma NGAL levels were increased in patients with acute and chronic heart failure as a complication of MI [ 86 ] NGAL prognosis value MI patients Higher baseline NGAL and a more significant increase in serum NGAL level were correlated with lower 6-month LV ejection fraction recovery [ 76 ] AMI patients 1. Plasma NGAL level was significantly higher in death patients than in survived patients of AMI 2.…”

“…Plasma NGAL level was significantly higher in death patients than in survived patients of AMI 2. Predict cardiovascular mortality in STEMI patients [ 86 ] STEMI patients 1. Plasm NGAL on day 12 could predict combined adverse outcomes 2.…”

Mortality prognosis of NGAL, NTproBNP, hsTnT, and GRACE score in patients with acute coronary syndrome

“…Our study showed the proportion of female patients was 51.7%, and the mean age was 67.48 ± 11.63. The patient's baseline characteristics were mostly similar in mean age, and difference in sex proportion [5] , [6] , [15] , [16] , [17] , [18] . Sex proportion was major sex was male from the study of Adnan Burak Akcay (2016) [6] , Katerina Helanova (2015) [5] , Peng-Ju Lu (2020) [15] , David Zahler (2022) [16] , Ahmet Avci (2020) [17] , and Alan S. Maisel (2011) [18] .…”

“…The patient's baseline characteristics were mostly similar in mean age, and difference in sex proportion [5] , [6] , [15] , [16] , [17] , [18] . Sex proportion was major sex was male from the study of Adnan Burak Akcay (2016) [6] , Katerina Helanova (2015) [5] , Peng-Ju Lu (2020) [15] , David Zahler (2022) [16] , Ahmet Avci (2020) [17] , and Alan S. Maisel (2011) [18] . Medical history of hypertension (70.7%); smoking (41.4%); lipid abnormalities (79.3%); and type 2 diabetes (24.1%).…”