Lipocalin-2 Predicts Long-Term Outcome of Normotensive Patients with Acute Pulmonary Embolism.

Abstract

Normotensive patients with acute pulmonary embolism (APE) are accompanied by heterogeneously adverse events. Responding to tissue injury, lipocalin-2 (LCN-2) is elevated in experimental APE model and associated with short-term prognosis. However, the prognostic value of LCN-2 in normotensive patients with APE for long-term major adverse events (MAEs) remains unknown. We evaluated the association of plasma LCN-2 levels with the median 467-day outcome in 170 normotensive patients with APE. We also assessed whether LCN-2 could improve risk stratification. MAEs consisted of mortality or recurrence of venous thromboembolism. During follow-up, 17 (10%) patients suffered from MAEs. These patients had higher LCN-2 levels compared with patients without MAEs (median: 13.97 vs. 8.55 ng/ml, P = 0.01). The proportion of MAEs in the intermediate-low-risk group (14.0%) was higher than that in the intermediate-high-risk group (5.3%). LCN-2 levels independently had prognostic value for MAEs in overall (HR = 3.40, 95% CI 1.46-7.90) and intermediate-risk group (HR = 3.88, 95% CI 1.63-9.23). LCN-2 also showed incremental value in overall (ΔC-index: 0.13, 95% CI 0.02-0.24; category-based NRI = 0.25, 95% CI 0.07-0.42) and intermediate-risk patients (ΔC-index: 0.13, 95% CI 0.05-0.31; category-based NRI = 0.44, 95% CI 0.24-0.65). Adding LCN-2 (cut-off value = 11 ng/ml) to the current risk algorithm improved MAEs of intermediate-risk reclassification (intermediate-high vs. intermediate-low = 25.6% vs. 6.0%, P = 0.002). Elevated plasma LCN-2 levels predict long-term MAEs among normotensive patients with APE. LCN-2 might be a useful biomarker for risk stratification in the intermediate-risk group.

• Authors: Haixu Yu, Zhuohui Liu, Jie Lu, Xinying Yang, Xin-Xin Yan, Yuhong Mi, Lu Hua, Yulin Li, Zhi-Cheng Jing, Jie Du
• Journal: Cardiovascular toxicology (Cardiovasc Toxicol) Vol. 20 Issue 2 Pg. 101-110 (04 2020) ISSN: 1559-0259 [Electronic] United States
• PMID: 31385242 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• LCN2 protein, human
• Lipocalin-2

Topics

• Aged
• Algorithms
• Biomarkers (blood)
• Decision Support Techniques
• Female
• Humans
• Lipocalin-2 (blood)
• Male
• Middle Aged
• Predictive Value of Tests
• Prognosis
• Pulmonary Embolism (blood, diagnosis, mortality)
• Recurrence
• Reproducibility of Results
• Risk Assessment
• Risk Factors
• Time Factors
• Up-Regulation
• Venous Thromboembolism (blood, diagnosis, mortality)