Department of Cardiology, Mustafa Kemal University, Tayfur Ata Sokmen Medical School, Hatay, Turkey.
J Investig Med. 2012 Feb;60(2):508-13. doi: 10.2310/JIM.0b013e31823e9d86.
This study investigated the prognostic value of neutrophil gelatinase-associated lipocalin (NGAL) in patients with ST-segment elevation myocardial infarction (STEMI).
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.
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.
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).
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.
本研究旨在探讨中性粒细胞明胶酶相关脂质运载蛋白（NGAL）在 ST 段抬高型心肌梗死（STEMI）患者中的预后价值。
中性粒细胞明胶酶相关脂质运载蛋白是急性肾损伤的一种有前途的生物标志物。最近的研究表明，NGAL 的应用可能超出了肾生理病理的范围。它被认为是间接参与炎症过程的重要因素。然而，关于其在 STEMI 中的预测作用，目前知之甚少。
连续纳入 106 例行经皮冠状动脉介入治疗（PCI）的 STEMI 患者，并与因胸痛接受择期 PCI 的 60 例年龄和性别匹配的对照组患者进行比较。根据 NGAL 中位数水平，患者被分为高 NGAL 组和低 NGAL 组。
与择期 PCI 组相比，STEMI 患者的 NGAL 水平更高。高 NGAL 组患者的住院期间和 1 年死亡率显著更高。此外，与低 NGAL 组相比，高 NGAL 组的住院期间和 1 年主要不良心血管事件发生率也显著更高。入院时的高 NGAL 水平是长期死亡率和主要不良心血管事件的显著预测因子。受试者工作特征曲线分析进一步表明，入院时的 NGAL 水平是死亡率的有力预测指标，曲线下面积为 0.76（95%置信区间，0.62-0.89）。
高 NGAL 水平可能与 STEMI 患者 PCI 后预后不良相关。然而，需要更多患者和更长随访时间的进一步研究来评估血浆 NGAL 水平对预测 STEMI 预后的有用性。
