Abstract 10250: The Association Between Neutrophil Gelatinase-Associated Lipocalin and Clinical Outcome in Chronic Heart Failure: Results From CORONA
Objective: To analyze (i) the relationships between Neutrophil gelatinase-associated lipocalin (NGAL) levels and clinical variables and biomarkers of heart failure (HF) in a large population of HF patients; (ii) the ability of NGAL to predict fatal and non-fatal outcomes in this population.
Background: NGAL is a marker of kidney injury as well as matrix degradation and inflammation, and has previously been shown to be increased in HF.
Methods and results: Plasma levels of NGAL and its relation to primary outcomes (cardiovascular death, non-fatal stroke and non-fatal myocardial infarction, n=398), and all cause mortality (n=414), cardiovascular mortality (n=338), hospitalizations (n=798) and number of hospitalizations (n=1934) was analyzed in 1415 patients with chronic HF (>60 years, NYHA class II-IV, ischemic systolic HF) in the CORONA population, randomly assigned to 10 mg rosuvastatin or placebo. NGAL levels were significantly correlated with impaired kidney function (eGFR), systemic inflammation (hsCRP) and the degree of HF (NT-proBNP). Multivariate analysis revealed that NGAL added significant information when adjusting for clinical variables, but was no longer significant when further adjusting for ApoB/ApoA-1, GFR and NT-proBNP. However, belonging to the highest NGAL tertile was associated with more frequent hospitalization, even after adjusting for clinical variables as well as GFR and ApoB/ApoA-1, but not after adjustment for NT-proBNP.
Conclusion: Although NGAL, as many other markers, is inferior to NT-proBNP as a predictive marker in HF, our findings may indicate an association between NGAL and the severity of HF, suggesting that NGAL could be added to the list of mediators that may be involved in the progression of this complex disorder.
- © 2011 by American Heart Association, Inc.