Abstract 14494: Prognostic Value of Serum Levels of Neutrophil Gelatinase-Associated Lipocalin on Admission in Patients Hospitalized to Coronary Care Units
Background: Neutrophil gelatinase-associated lipocalin (NGAL) is a measure of acute kidney injury. Renal dysfunction portends significant risk in patients admitted to coronary care units (CCUs). Thus, a sensitive marker of renal injury might also help to risk stratify patients hospitalized to CCUs. We prospectively investigated whether serum NGAL levels on admission is effective for the risk stratification in patients hospitalized to CCUs.
Methods: We measured serum NGAL, plasma B-type natriuretic peptide (BNP), urinary NGAL, urinary liver-type fatty-acid binding protein (L-FABP) levels on admission in 541 consecutive patients hospitalized to CCUs. Among these patients, heart failure was present in 55%, and acute coronary syndrome in 31%.
Results: Serum NGAL levels positively correlated with urinary NGAL levels (r = 0.43, p <0.0001). During a median follow-up period of 647 days after admission, there were 97 (18%) all-cause deaths including 75 cardiovascular deaths. Comparably, patients who died were older (median, 78 vs. 71 yrs, p <0.0001), had higher levels of serum NGAL (95 vs. 57 ng/ml, p < 0.0001), plasma BNP (792 vs. 169 pg/ml, p <0.0001), urinary NGAL (85 vs. 29 μg/g creatinine, p <0.0001), and urinary L-FABP (39 vs. 16 μg/g creatinine, p = 0.0003) and displayed a lower level of estimated glomerular filtration rate (43.3 vs. 63.9 ml/min/1.73m2, p <0.0001) than those who did not. In a stepwise Cox regression analysis including 11 clinical and biochemical variables, serum NGAL (p = 0.003), but not urinary NGAL and L-FABP, was independently associated with all-cause deaths. The quartiles of serum NGAL were associated with increased all-cause and cardiovascular mortality rates (Table).
Conclusion: Admission measurements of serum NGAL may be useful for evaluating the risk of mortality in patients admitted to CCUs.
- © 2013 by American Heart Association, Inc.