title: Early biomarkers of acute kidney failure after heart angiography or heart surgery in patients with acute coronary syndrome or acute heart failure.
abstract: BACKGROUND
  Acute kidney injury (AKI) is a common complication in cardiac surgery and coronary angiography, which worsens patients' prognosis. The diagnosis is based on the increase in serum creatinine, which is delayed. It is necessary to identify and validate new biomarkers that allow for early and effective interventions.
  
  
  OBJECTIVE
  To assess the sensitivity and specificity of neutrophil gelatinase-associated lipocalin in urine (uNGAL), interleukin-18 (IL-18) in urine and cystatin C in serum for the early detection of AKI in patients with acute coronary syndrome or heart failure, and who underwent cardiac surgery or catheterization.
  
  
  METHODS
  The study included 135 patients admitted to the intensive care unit for acute coronary syndrome or heart failure due to coronary or valvular pathology and who underwent coronary angiography or cardiac bypass surgery or valvular replacement. The biomarkers were determined 12 hours after surgery and serum creatinine was monitored during the next six days for the diagnosis of AKI.
  
  
  RESULTS
  The area under the ROC curve (AUC) for NGAL was 0.983, and for cystatin C and IL-18 the AUCs were 0.869 and 0.727, respectively. At a cut-off of 31.9 ng/ml for uNGAL the sensitivity was 100% and the specificity was 91%.
  
  
  CONCLUSIONS
  uNGAL is an early marker of AKI in patients with acute coronary syndrome or heart failure and undergoing cardiac surgery and coronary angiography, with a higher predictive value than cystatin C or IL-18.
authors: Servicio de Nefrología, Hospital Clínico Universitario de Valencia, Valencia. isist67@gmail.com
authors: Isidro
authors: I
authors: Torregrosa
authors: Carmina
authors: C
authors: Montoliu
authors: Amparo
authors: A
authors: Urios
authors: Nisrin
authors: N
authors: Elmlili
authors: María Jesús
authors: MJ
authors: Puchades
authors: Miguel Angel
authors: MA
authors: Solís
authors: Rafael
authors: R
authors: Sanjuán
authors: Maria Luisa
authors: ML
authors: Blasco
authors: Carmen
authors: C
authors: Ramos
authors: Patricia
authors: P
authors: Tomás
authors: José
authors: J
authors: Ribes
authors: Arturo
authors: A
authors: Carratalá
authors: Isabel
authors: I
authors: Juan
authors: Alfonso
authors: A
authors: Miguel
mesh_terms: D054058:Acute Coronary Syndrome / Q000601:surgery*; D000208:Acute Disease; D058186:Acute Kidney Injury / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000652:urine*; D000209:Acute-Phase Proteins / Q000652:urine*; D000368:Aged; D015415:Biomarkers / Q000097:blood / Q000652:urine; D006328:Cardiac Catheterization / Q000009:adverse effects; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D017023:Coronary Angiography / Q000009:adverse effects*; D055316:Cystatin C / Q000097:blood*; D042241:Early Diagnosis; D005260:Female; D006333:Heart Failure / Q000601:surgery*; D006801:Humans; D020382:Interleukin-18 / Q000652:urine*; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D008297:Male; D008875:Middle Aged; D011518:Proto-Oncogene Proteins / Q000652:urine*; D012680:Sensitivity and Specificity
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D055316:Cystatin C; D020382:Interleukin-18; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins