Prognostic significance of neutrophil gelatinase-associated lipocalin in ST-segment elevation myocardial infarction.
OBJECTIVE
This study investigated the prognostic value of neutrophil gelatinase-associated lipocalin (NGAL) in patients with ST-segment elevation myocardial infarction (STEMI).


BACKGROUND
Neutrophil gelatinase-associated lipocalin is a promising biomarker for acute kidney injury. Recently, it was concluded that NGAL may be used beyond the boundaries of renal physiopathology. It was found to be an important factor indirectly contributing to the inflammatory processes. Little is known regarding its predictive role in STEMI.


METHODS
One hundred six consecutive patients who underwent percutaneous coronary intervention (PCI) for STEMI and control group consisted of age- and sex-matched 60 consecutive patients with chest pain admitted to the hospital for elective PCI. According to median NGAL level, patients were classified into high- and low-NGAL groups.


RESULTS
Neutrophil gelatinase-associated lipocalin levels were higher in patients with STEMI compared to the elective PCI group subjects. Inhospital and 1-year mortality rates were found to be significantly greater in patients with high NGAL. In addition, inhospital and 1-year major adverse cardiovascular event rates were significantly greater in the high-NGAL group, compared to the low NGAL group. High NGAL level on admission was a significant predictor for long-term mortality and major adverse cardiovascular events. The receiver operating characteristics curve analysis further illustrated that NGAL level on admission is a strong indicator of mortality, with an area under the curve of 0.76 (95% confidence interval, 0.62-0.89).


CONCLUSIONS
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.
Department of Cardiology, Mustafa Kemal University, Tayfur Ata Sokmen Medical School, Hatay, Turkey.
Adnan Burak
AB
Akcay
Mehmet Fatih
MF
Ozlu
Nihat
N
Sen
Serkan
S
Cay
Oktay Hasan
OH
Ozturk
Fatih
F
Yalcn
Perihan
P
Bilen
Selcuk
S
Kanat
Mehmet Fatih
MF
Karakas
Ahmet
A
Isleyen
Ahmet Duran
AD
Demir
Sadik
S
Sogut
Adrian
A
Covic
Mehmet
M
Kanbay
D000209:Acute-Phase Proteins; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D011379:Prognosis; D016016:Proportional Hazards Models; D011518:Proto-Oncogene Proteins / Q000097:blood*; D012372:ROC Curve; D016896:Treatment Outcome
D000209:Acute-Phase Proteins; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins