Neutrophil Gelatinase-Associated Lipocalin for the Early Prediction of Acute Kidney Injury in ST-Segment Elevation Myocardial Infarction Patients Treated with Primary Percutaneous Coronary Intervention

Autor:	Ilana Goldiner, Aviram Hochstadt, Lior Fortis, Moshe Shtark, Yacov Shacham, Gad Keren, Keren-Lee Rozenfeld, Ilan Merdler, Itamar Loewenstein, David Zahler, Shmuel Banai
Rok vydání:	2020
Předmět:	Male medicine.medical_specialty Urology medicine.medical_treatment 030232 urology & nephrology 030204 cardiovascular system & hematology Lipocalin Sensitivity and Specificity 03 medical and health sciences chemistry.chemical_compound Percutaneous Coronary Intervention 0302 clinical medicine Lipocalin-2 Predictive Value of Tests medicine Humans ST segment Prospective Studies Myocardial infarction Israel Aged Aged 80 and over Creatinine business.industry Incidence Incidence (epidemiology) Acute kidney injury Percutaneous coronary intervention Acute Kidney Injury Middle Aged medicine.disease Kidney Tubules ROC Curve chemistry Conventional PCI ST Elevation Myocardial Infarction Female Cardiology and Cardiovascular Medicine business
Zdroj:	Cardiorenal Medicine. 10:154-161
ISSN:	1664-5502 1664-3828
DOI:	10.1159/000506378
Popis:	Introduction and Objective: Neutrophil gelatinase-associated lipocalin (NGAL), a glycoprotein released by renal tubular cells, can be used as a marker of early tubular damage. We evaluated plasma NGAL level utilization for the identification of acute kidney injury (AKI) among ST-elevation myocardial infarction (STEMI) patients undergoing primary coronary intervention (PCI). Methods: 131 STEMI patients treated with PCI were prospectively included. Plasma NGAL levels were drawn prior to PCI (0 h) and 24 h afterwards. AKI was defined per KDIGO criteria of serum creatinine increase. Receiver-operating characteristic (ROC) methods were used to identify optimal sensitivity and specificity for the observed NGAL range. Results: Overall AKI incidence was 14%. NGAL levels were significantly higher for patients with AKI at both 0 h (164 ± 42 vs. 95 ± 30; p < 0.001) and 24 h (142 ± 41 vs. 93 ± 36; p < 0.001). Per ROC curve analysis, an optimal cutoff value of NGAL (>120 ng/mL) predicted AKI with 80% sensitivity and specificity (AUC 0.881, 95%, CI 0.801–0.961, p < 0.001). In a multivariate logistic regression model, NGAL levels were independently associated with AKI at 0 h (OR 1.044, 95% CI 1.013–1.076; p = 0.005) and 24 h (OR 1.018, 95% CI 1.001–1.036; p = 0.04). Conclusions: Elevated NGAL levels, suggesting renal tubular damage, are independently associated with AKI in STEMI patients undergoing primary PCI.
Databáze:	OpenAIRE
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