Abstract
We aimed to assess the clinical significance of serum levels of neutrophil gelatinase-associated lipocalin (sNGAL) for predicting in-hospital outcomes in patients with ST-elevated myocardial infarction (STEMI). Patients admitted within 24 hours of developing STEMI clinical symptoms were evaluated for sNGAL on hospitalization days 1 and 12. Recurrent myocardial infarction, early post-infarction angina, acute cerebrovascular accident, and death were assessed as adverse outcomes during hospitalization. The actors associated with adverse outcome were evaluated using univariate and multivariate regression analysis. Among the 260 STEMI patients included, 32% had ≥1 adverse in-hospital outcome, and significantly higher sNGAL on day 12, (but not on day 1) compared to sNGAL in patients with favorable outcome (p = 0.033). Type-2 diabetes mellitus, age > 60 years, reduced glomerular filtration rate during hospitalization, and high sNGAL on day 12 were identified as risk factors for adverse in-hospital outcome, associated with a 14% increase for each 1-year increment in age after 60 years, and a dramatic increase (3.2 times) for high sNGAL on day 12, with sNGAL ≥ 1.046 ng/ml indicating complicated hospitalization course. sNGAL concentration on the 12th day was associated with the existing adverse outcomes, acting as a marker of MI severity.
Highlights
This was a retrospective evaluation of patients admitted between 2008 and 2010 to the Kemerovo Cardiology Hospital, in Kemerovo, Russia, with acute coronary syndrome characterized by ST-segment elevation
All patients were admitted within 24 hours of the moment of manifestation of clinical symptoms of ST-elevated myocardial infarction (STEMI)
The predictive role of Neutrophil gelatinase-associated lipocalin (NGAL) was shown in patients admitted to the emergency department with acute kidney injury (AKI), but who did not have any history of kidney disease [12]
Summary
Assessing the risk of adverse outcomes in patients with ST-elevated myocardial infarction (STEMI) represents a tasks in modern cardiology, and requires to analyze anamnestic data and the characteristics of the index coronary event, and the records of ongoing or progressing organ failures, which may complicate the course of the disease [1].
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