Abstract
Introduction Plasma neutrophil gelatinase-associated lipocalin (NGAL) levels in acute myocardial infarction (AMI) patients are markedly higher. In addition, plasma NGAL levels were increased in patients with acute and chronic heart failure as a complication of myocardial infarction. In this study, we investigated whether there is a difference between the prognostic use of plasma NGAL levels in ST-elevation myocardial infarction (STEMI) patients with preserved and reduced left ventricular ejection fraction (LVEF). Methods 235 consecutive STEMI patients were enrolled in the study. Patients were divided into groups according to LVEF. Plasma NGAL, troponin I, creatine kinase MB (CKMB), and C-reactive protein (CRP) were measured. Finally, the study population examined with 34 reduced LVEF and 34 preserved LVEF consisted of a total of 68 patients (12 females; mean age, 61.5 ± 14.7). All patients were followed up prospectively for 6 months. This study group was divided into two subgroups as the patients who died (n = 14) and survived (n = 34), and plasma NGAL levels of the groups were compared. Results The median of NGAL was 190.08 ng/ml. Age, troponin I, CKMB, CRP, glomerular filtration rate, and creatinine were higher in reduced LVEF groups. Plasma NGAL levels were also higher in reduced LVEF than in preserved LVEF, but statistically not significant (p=0.07). Plasma NGAL levels were significantly higher in death patients than in survived patients (p < 0.001). In ROC curve analysis, the level to detect isolated cardiovascular mortality with a sensitivity of 86% and a specificity of 77% was 190 ng/mL for NGAL. Conclusion Plasma NGAL levels can be used to predict cardiovascular mortality in STEMI patients.
Highlights
Plasma neutrophil gelatinase-associated lipocalin (NGAL) levels in acute myocardial infarction (AMI) patients are markedly higher
NGAL has been shown to be expressed in endothelial cells, smooth muscle cells, and macrophages in atherosclerotic plaques. e activity of matrix metalloproteinase-9 (MMP-9) is modulated through endothelial dysfunction, inflammatory processes, and matrix breakdown, and it causes the development of atherosclerotic plaque instability [4,5,6,7]
The studied population consisted of 68 patients (12 females (17.6%); mean age, 61.5 ± 14.7) with ST-elevation myocardial infarction (STEMI). e patients were divided into two groups as preserved left ventricular ejection fraction (LVEF) and reduced LVEF. e first group included the patients with LVEF ≥55. e patients with LVEF ≤35 were included in the second group
Summary
Plasma neutrophil gelatinase-associated lipocalin (NGAL) levels in acute myocardial infarction (AMI) patients are markedly higher. We investigated whether there is a difference between the prognostic use of plasma NGAL levels in ST-elevation myocardial infarction (STEMI) patients with preserved and reduced left ventricular ejection fraction (LVEF). NGAL is a secretory glycoprotein that can be detected at very low levels in physiological conditions in many human tissues, including the kidney, heart, stomach, lungs, and colon [1, 2]. It is especially well studied in the prediction of renal impairment; it is a well-known marker of renal dysfunction. NGAL is thought to play a role in cell survival, inflammation, and matrix disruption. is study aimed at identifying the relationship between short-term prognosis
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