Serum neutrophil gelatinase-associated lipocalin (NGAL) concentration is independently associated with mortality in patients with acute coronary syndrome.

Abstract

BACKGROUND:

Circulating neutrophil gelatinase-associated lipocalin (NGAL) concentration increases in cardiovascular disease, but the long-term prognostic value of NGAL concentration has not been evaluated in acute coronary syndrome (ACS). We examined the association between NGAL concentration and prognosis in patients with ACS after non-ST-elevation myocardial infarction (NSTEMI) or STEMI.

METHODS AND RESULTS:

NGAL concentration was measured in blood from 1121 consecutive ACS patients (30% women, mean age 65 years) on the first morning after admission. After adjustment for 14 variables, NGAL concentration predicted long-term (median 167 months) mortality (hazard ratio [HR] 1.33, 95% confidence interval [CI] 1.10-1.61, P = 0.003) for quartile (q) 4 of NGAL concentration. NGAL concentrations also predicted long-term mortality (HR = 1.63, 95% CI 1.31-2.03, P < 0.001, N = 741) when adjusting for Global Registry of Acute Coronary Events (GRACE) score, left ventricular ejection fraction (LVEF), and pro-B-type natriuretic peptide (proBNP) and C-reactive protein (CRP) concentrations. With these adjustments, NGAL concentration predicted long-term mortality in NSTEMI patients (HR = 2.02, 95% CI 1.50-2.72, P < 0.001) but not in STEMI patients (HR = 1.32, 95% CI 0.95-1.83, P = 0.100). In all patients, the combination of NGAL concentration and GRACE score yielded an HR of 5.56 (95% CI 4.37-7.06, P < 0.001) for q4/q4 for both variables.

CONCLUSION:

NGAL concentration in ACS is associated with long-term prognosis after adjustment for clinical confounders. Measuring circulating NGAL concentration may help to identify patients-particularly those with NSTEMI-needing closer follow-up after ACS.

• Authors: Ståle H Nymo, Marianne Hartford, Thor Ueland, Arne Yndestad, Erik Lorentzen, Katarina Truvé, Thomas Karlsson, Annica Ravn-Fischer, Pål Aukrust, Kenneth Caidahl
• Journal: International journal of cardiology (Int J Cardiol) Vol. 262 Pg. 79-84 (07 01 2018) ISSN: 1874-1754 [Electronic] Netherlands
• PMID: 29622507 (Publication Type: Journal Article)
• Copyright: Copyright © 2018. Published by Elsevier B.V.

Chemical References

• Biomarkers
• LCN2 protein, human
• Lipocalin-2

Topics

• Acute Coronary Syndrome (blood, mortality)
• Aged
• Biomarkers (blood)
• Electrocardiography
• Female
• Follow-Up Studies
• Humans
• Lipocalin-2 (blood)
• Male
• Middle Aged
• Prognosis
• Survival Rate (trends)
• Sweden (epidemiology)
• Time Factors