×
Home Current Archive Editorial board
News Contact
Review paper

Neutrophil gelatinase-associated lipocalin is a predictor of complications in the early phase of ST-elevation myocardial infarction

By
Nirvana Šabanović-Bajramović Orcid logo ,
Nirvana Šabanović-Bajramović
Contact Nirvana Šabanović-Bajramović

Intensive Care Unit, Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Centre University of Sarajevo , Sarajevo , Bosnia and Herzegovina

Enisa Hodžić ,
Enisa Hodžić

Intensive Care Unit, Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Centre University of Sarajevo , Sarajevo , Bosnia and Herzegovina

Amer Iglica ,
Amer Iglica

Intensive Care Unit, Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Centre University of Sarajevo , Sarajevo , Bosnia and Herzegovina

Edin Begić ,
Edin Begić

Department of Cardiology, General Hospital ''Prim.dr. Abdulah Nakaš" , Sarajevo , Bosnia and Herzegovina

Department of Pharmacology, School of Medicine, Sarajevo School of Science and Technology , Sarajevo , Bosnia and Herzegovina

Nerma Resić ,
Nerma Resić

Intensive Care Unit, Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Centre University of Sarajevo , Sarajevo , Bosnia and Herzegovina

Kenana Aganović ,
Kenana Aganović

Intensive Care Unit, Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Centre University of Sarajevo , Sarajevo , Bosnia and Herzegovina

Mirela Halilčević ,
Mirela Halilčević

Intensive Care Unit, Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Centre University of Sarajevo , Sarajevo , Bosnia and Herzegovina

Senad Bajramović
Senad Bajramović

Urology Clinic, Clinical Centre of the University of Sarajevo , Sarajevo , Bosnia and Herzegovina

Abstract

Aim
To evaluate a correlation of serum level of neutrophil gelatinase-associated lipocalin (NGAL) to the risk of the occurrence of complications in patients with the early phase of ST-segment elevation myocardical infarction (STEMI) treated with fibrinolytic therapy prior to percutaneous coronary intervention (PCI).
Methods
A total of 54 patients with the diagnosis of STEMI treated with fibrinolytic therapy (alteplase) prior to PCI were included. Patients were admitted to the Intensive Care Unit (ICU) of Clinic for Heart, Blood Vessel and Rheumatic Diseases in the period January to March 2018. All patients underwent coronary angiography and PCI within the maximum of 48 hours delay after fibrinolysis, according to the hemodynamic and electrical stability and PCI availability. Blood samples were taken immediately after admission prior to fibrinolytic administration. Patients were divided into two groups according to NGAL values (less or more than 134.05 ng/mL).
Results
Higher values of NGAL have effect on a higher mean systolic and diastolic pressure (p=0.001 and p=0.003, respectively). Patients with higher NGAL values also have higher values of brain natriuretic peptide (p=0.0001) and highly sensitive troponin I (p=0.002). In that group relative risk (RR) for lethal outcome was 6.4 times significantly higher (p=0.002), for the development of heart failure 2.88 times (p=0.0002), for post-myocardial infarction angina pectoris 2.24 times (p=0.0158), and for ventricular rhythm disturbances (ventricular tachycardia, ventricular fibrillation) 1.96 times higher (p=0.0108).
Conclusion
Increased NGAL value is related to an unfavourable outcome of patients in the early phase of STEMI treated with fibrinolytic therapy prior to PCI.

References

1.
Pedersen K, Ravn H, Hjortdal V, Nørregaard R, Povlsen J. Neutrophil gelatinase-associated lipocalin (NGAL): validation of commercially available ELISA. Scand J Clin Lab Invest. 2010;374–82.
2.
Haase-Fielitz A, Haase M, Devarajan P. Neutrophil gelatinase-associated lipocalin as a biomarker of acute kidney injury: a critical evaluation of current status. Ann Clin Biochem. 2014;335–51.
3.
Mcilroy D, Wagener G, Lee H. Neutrophil gelatinase-associated lipocalin and acute kidney injury after cardiac surgery: the effect of baseline renal function on diagnostic performance. Clin J Am Soc Nephrol. 2010;211–9.
4.
Bachorzewska-Gajewska H, Malyszko J, Sitniewska E, Malyszko J, Poniatowski B, Pawlak K, et al. NGAL (neutrophil gelatinase-associated lipocalin) and cystatin C: are they good predictors of contrast nephropathy after percutaneous coronary interventions in patients with stable angina and normal serum creatinine? Int J Cardiol. 2008;290–1.
5.
Barreto R, Elia C, Solà E, Moreira R, Ariza X, Rodríguez E, et al. Urinary neutrophil gelatinase-associated lipocalin predicts kidney outcome and death in patients with cirrhosis and bacterial infections. J Hepatol. 2014;35–42.
6.
Verna E, Brown R, Pichardo F, Forster E, C, Valle SD, et al. Urinary neutrophil gelatinase-associated lipocalin predicts mortality and identifies acute kidney injury in cirrhosis. Dig Dis Sci. 2012;2362–70.
7.
Noto A, Cibecchini F, Fanos V, Mussap M. NGAL and metabolomics: the single biomarker to reveal the metabolome alterations in kidney injury. Biomed Res Int. 2013;612032.
8.
Mishra J, Qing M, Prada A, Mitsnefes M, Zahedi K, Yang J, et al. Identification of neutrophil gelatinase-associated lipocalin as a novel early urinary biomarker for ischemic renal injury. J Am Soc Nephrol. 2003;2534–43.
9.
Palazzuoli A, Beltrami M, Pellegrini M, Nuti R. Natriuretic peptides and NGAL in heart failure: does a link exist? Clin Chim Acta. 2012;1832–8.
10.
Aghel A, Shrestha K, Mullens W, Borowski A, Tang W. Serum neutrophil gelatinase-associated lipocalin (NGAL) in predicting worsening renal function in acute decompensated heart failure. J Card Fail. 2010;49–54.
11.
Van Deursen V, Damman K, Voors A, Van Der Wal M, Jaarsma T, Van Veldhuisen D, et al. Prognostic value of plasma neutrophil gelatinase-associated lipocalin for mortality in patients with heart failure. Circ Heart Fail. 2014;35–42.
12.
Kirbis S, Gorenjak M, Sinkovic A. The role of urine neutrophil gelatinase--associated lipocalin (NGAL) in acute heart failure in patients with ST--elevation myocardial infarction. BMC Cardiovasc Disord. 2015;49.
13.
Leopold J. The Central Role of Neutrophil Gelatinase-Associated Lipocalin in Cardiovascular Fibrosis. Hypertension. 2015;20–2.
14.
Lindberg S, Pedersen S, Mogelvang R, Jensen J, Flyvbjerg A, Galatius S, et al. Prognostic utility of neutrophil gelatinase-associated lipocalin in predicting mortality and cardiovascular events in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. J Am Coll Cardiol. 2012;339–45.
15.
Mozos I. Laboratory markers of ventricular arrhythmia risk in renal failure. Biomed Res Int. 2014;509204.
16.
Elmer J, Jeong K, Abebe K, Guyette F, Murugan R, Callaway C, et al. Crit Care Med. 2016;111–9.
17.
Gharishvandi F, Kazerouni F, Ghanei E, Rahimipour A, Nasiri M. Comparative assessment of neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C as early biomarkers for early detection of renal failure in patients with hypertension. Iran Biomed J. 2015;76–81.
18.
Singer E, Schrezenmeier E, Elger A, Seelow E, Krannich A, Luft F, et al. Urinary NGAL-Positive Acute Kidney Injury and Poor Long-term Outcomes in Hospitalized Patients. Kidney Int Rep. 2016;114–24.
19.
Eirin A, Gloviczki M, Tang H, Rule A, Woollard J, Lerman A, et al. Chronic renovascular hypertension is associated with elevated levels of neutrophil gelatinase-associated lipocalin. Nephrol Dial Transplant. 2012;4153–61.
20.
Kim I, Kim J, Kim M, Lee D, Hwang C, Han M, et al. Plasma neutrophil gelatinase-associated lipocalin is independently associated with left ventricular hypertrophy and diastolic dysfunction in patients with chronic kidney disease. PLoS One. 2018;205848.
21.
Nakada Y, Kawakami R, Matsui M, Ueda T, Nakano T, Takitsume A, et al. Prognostic value of urinary neutrophil gelatinase-associated lipocalin on the first day of admission for adverse events in patients with acute decompensated heart failure. J Am Heart Assoc. 2017;4582.
22.
Maisel A, Wettersten N, Van Veldhuisen D, Mueller C, Filippatos G, Nowak R, et al. Neutrophil gelatinase-associated lipocalin for acute kidney injury during acute heart failure hospitalizations: the AKI-NESIS Study. J Am Coll Cardiol. 2016;1420–31.
23.
Aa AA. Prognostic value of neutrophil gelatinase-associated lipocalin in predicting in-hospital complications in patients with st-segment elevation myocardial infarction. Research Journal of Cardiology. 2013;10–8.
24.
Kafkas N, Demponeras C, Zoubouloglou F, Spanou D, Babalis D, Makris K. Serum levels of gelatinase associated lipocalin as indicator of the inflammatory status in coronary artery disease. Int J Inflammation. 2012;189797.
25.
Akcay A, Ozlu M, Sen N, Cay S, Ozturk O. Prognostic significance of neutrophil gelatinase-associated lipocalin in ST-segment elevation myocardial infarction. J Invset Med. 2012;508–13.
26.
Sarndahl E, Bergstrom I, Brodin V, Nijm J, Setterud H, Jonasson L. Neutrophil activation status in stable coronary artery disease. PLoS One. 2007;e1056.
27.
Yndestad A, Landrø L, Ueland T, Dahl C, Flo T, Vinge L, et al. Increased systemic and myocardial expression of neutrophil gelatinase-associated lipocalin in clinical and experimental heart failure. Eur Heart J. 2009;1229–36.
28.
Daniels L, Barrett-Connor E, Clopton P, Laughlin G, Ix J, Maisel A. Plasma neutrophil gelatinaseassociated lipocalin is independently associated with cardiovascular disease and mortality in communitydwelling older adults: The Rancho Bernardo Study. J Am Coll Cardiol. 2012;1101–9.
29.
Martínez-Martínez E, Buonafine M, Boukhalfa I, Ibarrola J, Fernández-Celis A, Kolkhof P, et al. Aldosterone target NGAL (neutrophil gelatinase-associated lipocalin) is involved in cardiac remodeling after myocardial infarction through NFκB pathway. Hypertension. 2017;1148–56.
30.
Marques F, Prestes P, Byars S, Ritchie S, Würtz P, Patel S, et al. Experimental and human evidence for lipocalin-2 (neutrophil gelatinase-associated lipocalin [NGAL]) in the development of cardiac hypertrophy and heart failure. J Am Heart Assoc. 2017;5971.
31.
Chou W, Wang G, Kumar V, Weng Y. Lipocalin-2 in Stroke. Neuro. 2015;38–41.
32.
Hsu W, Chiou H, Tung K, Belot G, Virilli A, Wong M, et al. The different molecular forms of urine neutrophil gelatinase-associated lipocalin present in dogs with urinary diseases. BMC Vet Res. 2014;202.
33.
Cai L, Rubin J, Han W, Venge P, Xu S. The origin of multiple molecular forms in urine of HNL/ NGAL. Clin J Am Soc Nephrol. 2010;2229–35.
34.
Bouchet S, Bauvois B. Neutrophil gelatinase -associated lipocalin (NGAL), pro-matrix metalloproteinase-9 (pro-MMP-9) and their complex pro-MMP-9/ NGAL in leukaemias. Cancers. 2014;796–812.
35.
Lippi G, Cervellin G. Neutrophil gelatinase-associated lipocalin: a more specific assay is needed for diagnosing renal injury. Clin Chim Acta. 2012;1160–1.
36.
Leclercq A, Houard X, Philippe M, Ollivier V, Sebbag U, Meilhac O, et al. Involvement of intraplaque hemorrhage in atherothrombosis evolution via neutrophil protease enrichment. J Leukoc Biol. 2007;1420–9.
37.
Hemdahl A, Gabrielsen A, Zhu C, Eriksson P, Hedin U, Kastrup J, et al. Expression of neutrophil gelatinase-associated lipocalin in atherosclerosis and myocardial infarction. Arterioscler Thromb Vasc Biol. 2006;136–42.
38.
Helanova K, Spinar J, Parenica J. Diagnostic and prognostic utility of neutrophil gelatinase-associated lipocalin (NGAL) in patients with cardiovascular diseases -review. Kidney Blood Press Res. 2014;623–9.

Citation

Authors retain copyright. This work is licensed under a Creative Commons Attribution 4.0 International License. Creative Commons License

 

Article metrics

Google scholar: See link

The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.