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Prognostic Significance of Neutrophil Gelatinase–Associated Lipocalin in ST-Segment Elevation Myocardial Infarction
  1. Adnan Burak Akcay, MD*,
  2. Mehmet Fatih Ozlu, MD,
  3. Nihat Sen, MD*,
  4. Serkan Cay, MD,
  5. Oktay Hasan Ozturk, MD, PhD,
  6. Fatih Yalıcn, MD§,
  7. Perihan Bilen, MD*,
  8. Selcuk Kanat, MD,
  9. Mehmet Fatih Karakas, MD,
  10. Ahmet Isleyen, MD,
  11. Ahmet Duran Demir, MD,
  12. Sadik Sogut, MD, PhD,
  13. Adrian Covic, MD, PhD, FRCP,
  14. Mehmet Kanbay, MD#
  1. From the *Department of Cardiology, Mustafa Kemal University, Tayfur Ata Sokmen Medical School, Hatay, Turkey; †Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey; ‡Department of Biochemistry, Mustafa Kemal University, Tayfur Ata Sokmen Medical School, Hatay, Turkey; §Department of Cardiology, Mustafa Kemal University School of Medicine, Hatay, Turkey; ∥Faculty of Medicine, Department of Biochemistry, Bezmialem Vakif University, Istanbul; ¶Nephrology Clinic, Dialysis and Renal Transplant Center,“C.I. PARHON” University Hospital, “Gr. T. Popa” University of Medicine and Pharmacy, Iasi, Romania; and #Division of Nephrology, Department of Medicine, Kayseri Training and Research Hospital, Kayseri, Turkey.
  1. Received July 29, 2011, and in revised form September 25, 2011.
  2. Accepted for publication September 30, 2011.
  3. Reprints: Mehmet Kanbay, MD, Division of Nephrology, Department of Medicine, Kayseri Training and Research Hospital, Kayseri, Turkey. E-mail: drkanbay{at}yahoo.com.

Abstract

Objectives 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.

Key Words
  • ST-segment elevation myocardial infarction
  • neutrophil gelatinase–associated lipocalin
  • prognosis

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