Neutrophil Gelatinase-Associated Lipocalin (NGAL) in Patients with ST-Elevation Myocardial Infarction and Its Association with Acute Kidney Injury and Mortality
Neutrophil gelatinase-associated lipocalin (NGAL) is an inflammatory biomarker related to acute kidney injury (AKI). Including 1892 consecutive patients with ST-elevation myocardial infarction (STEMI), in which NGAL was measured in 1624 (86%) on admission and in a consecutive subgroup at 6–12 h (n =...
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| Format: | Article |
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MDPI AG
2023-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/11/3681 |
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| author | Mathias Alexander Højagergaard Rasmus Paulin Beske Christian Hassager Lene Holmvang Lisette Okkels Jensen Yacov Shacham Martin Abild Stengaard Meyer Jacob Eifer Moeller Ole Kristian Lerche Helgestad Peter Dall Mark Rasmus Møgelvang Martin Frydland |
| author_facet | Mathias Alexander Højagergaard Rasmus Paulin Beske Christian Hassager Lene Holmvang Lisette Okkels Jensen Yacov Shacham Martin Abild Stengaard Meyer Jacob Eifer Moeller Ole Kristian Lerche Helgestad Peter Dall Mark Rasmus Møgelvang Martin Frydland |
| author_sort | Mathias Alexander Højagergaard |
| collection | DOAJ |
| description | Neutrophil gelatinase-associated lipocalin (NGAL) is an inflammatory biomarker related to acute kidney injury (AKI). Including 1892 consecutive patients with ST-elevation myocardial infarction (STEMI), in which NGAL was measured in 1624 (86%) on admission and in a consecutive subgroup at 6–12 h (n = 163) and 12–24 h (n = 222) after admission, this study aimed to evaluate the prognostic value of NGAL in predicting AKI and mortality. Patients were stratified based on whether their admission NGAL plasma concentration was greater than or equal to/less than the median. The primary endpoint was a composite of the first occurrence of AKI or all-cause death within 30 days. AKI was classified by the maximal plasma creatinine increase from baseline during index admission as KDIGO1 (<200% increase) or KDIGO23 (≥200% increase) according to the Kidney Disease Improving Global Outcomes (KDIGO) system. Admission NGAL > the median was independently associated with a higher risk of severe AKI (KDIGO2-3) and 30-day all-cause mortality when adjusted for age, admission systolic blood pressure and high-sensitivity C-reactive protein, left-ventricular ejection fraction, known kidney dysfunction, and cardiogenic shock with an odds ratio (95% confidence interval) of 2.26 (1.18–4.51), <i>p</i> = 0.014. Finally, we observed increasing predictive values in a subgroup during the first day of hospitalization suggesting that assessment of NGAL should be delayed for optimal prognostic purposes. |
| first_indexed | 2024-03-11T03:03:23Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T03:03:23Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-2de8120704974e0dbbadb031b9f831f02023-11-18T08:05:01ZengMDPI AGJournal of Clinical Medicine2077-03832023-05-011211368110.3390/jcm12113681Neutrophil Gelatinase-Associated Lipocalin (NGAL) in Patients with ST-Elevation Myocardial Infarction and Its Association with Acute Kidney Injury and MortalityMathias Alexander Højagergaard0Rasmus Paulin Beske1Christian Hassager2Lene Holmvang3Lisette Okkels Jensen4Yacov Shacham5Martin Abild Stengaard Meyer6Jacob Eifer Moeller7Ole Kristian Lerche Helgestad8Peter Dall Mark9Rasmus Møgelvang10Martin Frydland11Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Cardiology, Odense University Hospital, 5230 Odense, DenmarkDepartment of Cardiology, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, IsraelDepartment of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Cardiology, Odense University Hospital, 5230 Odense, DenmarkDepartment of Clinical Biochemistry, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, DenmarkCentre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, DenmarkNeutrophil gelatinase-associated lipocalin (NGAL) is an inflammatory biomarker related to acute kidney injury (AKI). Including 1892 consecutive patients with ST-elevation myocardial infarction (STEMI), in which NGAL was measured in 1624 (86%) on admission and in a consecutive subgroup at 6–12 h (n = 163) and 12–24 h (n = 222) after admission, this study aimed to evaluate the prognostic value of NGAL in predicting AKI and mortality. Patients were stratified based on whether their admission NGAL plasma concentration was greater than or equal to/less than the median. The primary endpoint was a composite of the first occurrence of AKI or all-cause death within 30 days. AKI was classified by the maximal plasma creatinine increase from baseline during index admission as KDIGO1 (<200% increase) or KDIGO23 (≥200% increase) according to the Kidney Disease Improving Global Outcomes (KDIGO) system. Admission NGAL > the median was independently associated with a higher risk of severe AKI (KDIGO2-3) and 30-day all-cause mortality when adjusted for age, admission systolic blood pressure and high-sensitivity C-reactive protein, left-ventricular ejection fraction, known kidney dysfunction, and cardiogenic shock with an odds ratio (95% confidence interval) of 2.26 (1.18–4.51), <i>p</i> = 0.014. Finally, we observed increasing predictive values in a subgroup during the first day of hospitalization suggesting that assessment of NGAL should be delayed for optimal prognostic purposes.https://www.mdpi.com/2077-0383/12/11/3681Neutrophil gelatinase-associated lipocalinNGALST-elevation myocardial infarctionSTEMIacute myocardial infarctionacute kidney injury |
| spellingShingle | Mathias Alexander Højagergaard Rasmus Paulin Beske Christian Hassager Lene Holmvang Lisette Okkels Jensen Yacov Shacham Martin Abild Stengaard Meyer Jacob Eifer Moeller Ole Kristian Lerche Helgestad Peter Dall Mark Rasmus Møgelvang Martin Frydland Neutrophil Gelatinase-Associated Lipocalin (NGAL) in Patients with ST-Elevation Myocardial Infarction and Its Association with Acute Kidney Injury and Mortality Journal of Clinical Medicine Neutrophil gelatinase-associated lipocalin NGAL ST-elevation myocardial infarction STEMI acute myocardial infarction acute kidney injury |
| title | Neutrophil Gelatinase-Associated Lipocalin (NGAL) in Patients with ST-Elevation Myocardial Infarction and Its Association with Acute Kidney Injury and Mortality |
| title_full | Neutrophil Gelatinase-Associated Lipocalin (NGAL) in Patients with ST-Elevation Myocardial Infarction and Its Association with Acute Kidney Injury and Mortality |
| title_fullStr | Neutrophil Gelatinase-Associated Lipocalin (NGAL) in Patients with ST-Elevation Myocardial Infarction and Its Association with Acute Kidney Injury and Mortality |
| title_full_unstemmed | Neutrophil Gelatinase-Associated Lipocalin (NGAL) in Patients with ST-Elevation Myocardial Infarction and Its Association with Acute Kidney Injury and Mortality |
| title_short | Neutrophil Gelatinase-Associated Lipocalin (NGAL) in Patients with ST-Elevation Myocardial Infarction and Its Association with Acute Kidney Injury and Mortality |
| title_sort | neutrophil gelatinase associated lipocalin ngal in patients with st elevation myocardial infarction and its association with acute kidney injury and mortality |
| topic | Neutrophil gelatinase-associated lipocalin NGAL ST-elevation myocardial infarction STEMI acute myocardial infarction acute kidney injury |
| url | https://www.mdpi.com/2077-0383/12/11/3681 |
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