Prognostic Value of Urinary Neutrophil Gelatinase‐Associated Lipocalin on the First Day of Admission for Adverse Events in Patients With Acute Decompensated Heart Failure
BackgroundUrinary neutrophil gelatinase‐associated lipocalin (U‐NGAL) is an early predictor of acute kidney injury and adverse events in various diseases; however, in acute decompensated heart failure patients, its significance remains poorly understood. This study aimed to investigate the prognosti...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2017-05-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.116.004582 |
| _version_ | 1818315112270790656 |
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| author | Yasuki Nakada Rika Kawakami Masaru Matsui Tomoya Ueda Tomoya Nakano Akihiro Takitsume Hitoshi Nakagawa Taku Nishida Kenji Onoue Tsunenari Soeda Satoshi Okayama Makoto Watanabe Hiroyuki Kawata Hiroyuki Okura Yoshihiko Saito |
| author_facet | Yasuki Nakada Rika Kawakami Masaru Matsui Tomoya Ueda Tomoya Nakano Akihiro Takitsume Hitoshi Nakagawa Taku Nishida Kenji Onoue Tsunenari Soeda Satoshi Okayama Makoto Watanabe Hiroyuki Kawata Hiroyuki Okura Yoshihiko Saito |
| author_sort | Yasuki Nakada |
| collection | DOAJ |
| description | BackgroundUrinary neutrophil gelatinase‐associated lipocalin (U‐NGAL) is an early predictor of acute kidney injury and adverse events in various diseases; however, in acute decompensated heart failure patients, its significance remains poorly understood. This study aimed to investigate the prognostic value of U‐NGAL on the first day of admission for the occurrence of acute kidney injury and long‐term outcomes in acute decompensated heart failure patients. Methods and ResultsWe studied 260 acute decompensated heart failure patients admitted to our department between 2011 and 2014 by measuring U‐NGAL in 24‐hour urine samples collected on the first day of admission. Primary end points were all‐cause death, cardiovascular death, and heart failure admission. Patients were divided into 2 groups according to their median U‐NGAL levels (32.5 μg/gCr). The high‐U‐NGAL group had a significantly higher occurrence of acute kidney injury during hospitalization than the low‐U‐NGAL group (P=0.0012). Kaplan‐Meier analysis revealed that the high‐U‐NGAL group exhibited a worse prognosis than the low‐U‐NGAL group in all‐cause death (hazard ratio 2.07; 95%CI 1.38‐3.12, P=0.0004), cardiovascular death (hazard ratio 2.29; 95%CI 1.28‐4.24, P=0.0052), and heart failure admission (hazard ratio 1.77; 95%CI 1.13‐2.77, P=0.0119). The addition of U‐NGAL to the estimated glomerular filtration rate significantly improved the predictive accuracy of all‐cause mortality (P=0.0083). ConclusionsIn acute decompensated heart failure patients, an elevated U‐NGAL level on the first day of admission was related to the development of clinical acute kidney injury and independently associated with poor prognosis. |
| first_indexed | 2024-12-13T09:00:21Z |
| format | Article |
| id | doaj.art-645acabae8164f32bdb7dd8f6d145421 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T09:00:21Z |
| publishDate | 2017-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-645acabae8164f32bdb7dd8f6d1454212022-12-21T23:53:11ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802017-05-016510.1161/JAHA.116.004582Prognostic Value of Urinary Neutrophil Gelatinase‐Associated Lipocalin on the First Day of Admission for Adverse Events in Patients With Acute Decompensated Heart FailureYasuki Nakada0Rika Kawakami1Masaru Matsui2Tomoya Ueda3Tomoya Nakano4Akihiro Takitsume5Hitoshi Nakagawa6Taku Nishida7Kenji Onoue8Tsunenari Soeda9Satoshi Okayama10Makoto Watanabe11Hiroyuki Kawata12Hiroyuki Okura13Yoshihiko Saito14First Department of Internal Medicine, Nara Medical University, Kashihara Nara, JapanFirst Department of Internal Medicine, Nara Medical University, Kashihara Nara, JapanFirst Department of Internal Medicine, Nara Medical University, Kashihara Nara, JapanFirst Department of Internal Medicine, Nara Medical University, Kashihara Nara, JapanFirst Department of Internal Medicine, Nara Medical University, Kashihara Nara, JapanFirst Department of Internal Medicine, Nara Medical University, Kashihara Nara, JapanFirst Department of Internal Medicine, Nara Medical University, Kashihara Nara, JapanFirst Department of Internal Medicine, Nara Medical University, Kashihara Nara, JapanFirst Department of Internal Medicine, Nara Medical University, Kashihara Nara, JapanFirst Department of Internal Medicine, Nara Medical University, Kashihara Nara, JapanFirst Department of Internal Medicine, Nara Medical University, Kashihara Nara, JapanFirst Department of Internal Medicine, Nara Medical University, Kashihara Nara, JapanFirst Department of Internal Medicine, Nara Medical University, Kashihara Nara, JapanFirst Department of Internal Medicine, Nara Medical University, Kashihara Nara, JapanFirst Department of Internal Medicine, Nara Medical University, Kashihara Nara, JapanBackgroundUrinary neutrophil gelatinase‐associated lipocalin (U‐NGAL) is an early predictor of acute kidney injury and adverse events in various diseases; however, in acute decompensated heart failure patients, its significance remains poorly understood. This study aimed to investigate the prognostic value of U‐NGAL on the first day of admission for the occurrence of acute kidney injury and long‐term outcomes in acute decompensated heart failure patients. Methods and ResultsWe studied 260 acute decompensated heart failure patients admitted to our department between 2011 and 2014 by measuring U‐NGAL in 24‐hour urine samples collected on the first day of admission. Primary end points were all‐cause death, cardiovascular death, and heart failure admission. Patients were divided into 2 groups according to their median U‐NGAL levels (32.5 μg/gCr). The high‐U‐NGAL group had a significantly higher occurrence of acute kidney injury during hospitalization than the low‐U‐NGAL group (P=0.0012). Kaplan‐Meier analysis revealed that the high‐U‐NGAL group exhibited a worse prognosis than the low‐U‐NGAL group in all‐cause death (hazard ratio 2.07; 95%CI 1.38‐3.12, P=0.0004), cardiovascular death (hazard ratio 2.29; 95%CI 1.28‐4.24, P=0.0052), and heart failure admission (hazard ratio 1.77; 95%CI 1.13‐2.77, P=0.0119). The addition of U‐NGAL to the estimated glomerular filtration rate significantly improved the predictive accuracy of all‐cause mortality (P=0.0083). ConclusionsIn acute decompensated heart failure patients, an elevated U‐NGAL level on the first day of admission was related to the development of clinical acute kidney injury and independently associated with poor prognosis.https://www.ahajournals.org/doi/10.1161/JAHA.116.004582acute heart failureacute kidney injuryneutrophil gelatinase‐associated lipocalinoutcomes |
| spellingShingle | Yasuki Nakada Rika Kawakami Masaru Matsui Tomoya Ueda Tomoya Nakano Akihiro Takitsume Hitoshi Nakagawa Taku Nishida Kenji Onoue Tsunenari Soeda Satoshi Okayama Makoto Watanabe Hiroyuki Kawata Hiroyuki Okura Yoshihiko Saito Prognostic Value of Urinary Neutrophil Gelatinase‐Associated Lipocalin on the First Day of Admission for Adverse Events in Patients With Acute Decompensated Heart Failure Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease acute heart failure acute kidney injury neutrophil gelatinase‐associated lipocalin outcomes |
| title | Prognostic Value of Urinary Neutrophil Gelatinase‐Associated Lipocalin on the First Day of Admission for Adverse Events in Patients With Acute Decompensated Heart Failure |
| title_full | Prognostic Value of Urinary Neutrophil Gelatinase‐Associated Lipocalin on the First Day of Admission for Adverse Events in Patients With Acute Decompensated Heart Failure |
| title_fullStr | Prognostic Value of Urinary Neutrophil Gelatinase‐Associated Lipocalin on the First Day of Admission for Adverse Events in Patients With Acute Decompensated Heart Failure |
| title_full_unstemmed | Prognostic Value of Urinary Neutrophil Gelatinase‐Associated Lipocalin on the First Day of Admission for Adverse Events in Patients With Acute Decompensated Heart Failure |
| title_short | Prognostic Value of Urinary Neutrophil Gelatinase‐Associated Lipocalin on the First Day of Admission for Adverse Events in Patients With Acute Decompensated Heart Failure |
| title_sort | prognostic value of urinary neutrophil gelatinase associated lipocalin on the first day of admission for adverse events in patients with acute decompensated heart failure |
| topic | acute heart failure acute kidney injury neutrophil gelatinase‐associated lipocalin outcomes |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.116.004582 |
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