Avci Ahmet, Ozturk Bahadir, Demir Kenan, Akyürek Fikret, Altunkeser Bulent Behlul
Zonguldak Bulent Ecevit University, Faculty of Medicine Cardiology Department, Zonguldak, Turkey.
Selcuk University, Faculty of Medicine Biochemistry Department, Konya, Turkey.
Adv Prev Med. 2020 Aug 30;2020:4637043. doi: 10.1155/2020/4637043. eCollection 2020.
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).
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 ( = 14) and survived ( = 34), and plasma NGAL levels of the groups were compared.
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 (=0.07). Plasma NGAL levels were significantly higher in death patients than in survived patients ( < 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.
Plasma NGAL levels can be used to predict cardiovascular mortality in STEMI patients.
急性心肌梗死（AMI）患者血浆中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平显著升高。此外，作为心肌梗死并发症的急性和慢性心力衰竭患者血浆NGAL水平也会升高。在本研究中，我们调查了左心室射血分数（LVEF）正常和降低的ST段抬高型心肌梗死（STEMI）患者，血浆NGAL水平用于预后评估时是否存在差异。
235例连续的STEMI患者纳入本研究。根据LVEF将患者分组。检测血浆NGAL、肌钙蛋白I、肌酸激酶MB（CKMB）和C反应蛋白（CRP）。最后，研究人群包括34例LVEF降低和34例LVEF正常的患者，共68例（12例女性；平均年龄61.5±14.7岁）。所有患者进行前瞻性随访6个月。该研究组分为死亡（=14）和存活（=34）两个亚组，并比较两组的血浆NGAL水平。
NGAL的中位数为190.08 ng/ml。LVEF降低组的年龄、肌钙蛋白I、CKMB、CRP、肾小球滤过率和肌酐更高。LVEF降低组的血浆NGAL水平也高于LVEF正常组，但差异无统计学意义（=0.07）。死亡患者的血浆NGAL水平显著高于存活患者（<0.001）。在ROC曲线分析中，NGAL检测孤立性心血管死亡的水平为190 ng/mL，灵敏度为86%，特异性为77%。
血浆NGAL水平可用于预测STEMI患者的心血管死亡率。
