Abstract 19528: Association of Neutrophil Gelatinase-Associated Lipocalin With Mortality and Cardiovascular Events: Results From the Dallas Heart Study
Background: Neutrophil gelatinase-associated lipocalin (NGAL), a small protein located primarily in activated neutrophils, has been implicated in the prediction of adverse cardiovascular (CV) events in patients without pre-existing CV disease. However, prior cohorts have been limited by size, homogeneous race/ethnicity, and older age.
Methods: Plasma NGAL levels were measured in participants enrolled in the Dallas Heart Study, a multi-ethnic probability based sample of Dallas County residents ages 30-65. After excluding patients with a history of myocardial infarction, stroke, or heart failure (n=255), a total of 3043 participants were included and followed for clinical events. NGAL was log-transformed and analyzed in Cox proportional hazards models adjusted for age, sex, race, diabetes status, hypertension, body mass index, tobacco use, and renal function. Outcomes included all-cause death, CV death, and nonfatal CV events.
Results: Over a median follow-up period of 6.4 years, 173 total deaths occurred (5.7%), including 61 CV deaths, which represented 35% of all deaths. Over the same follow-up period, there were 85 incident CVAs (49%) or MIs (51%). Higher plasma NGAL was associated with increased risk of both all-cause (HR per 1 SD: 1.35, 95% CI 1.15-1.58) and CV mortality (HR per 1 SD: 1.47, 95% CI 1.12-1.91). Higher NGAL was also significantly associated with increased risk of MI (HR per 1 SD: 1.65, 95% CI 1.20-2.26) and CVA (HR per 1 SD: 1.56, 95% CI 1.14-2.11).
Conclusion: In this population based cohort, larger, younger, and more racially/ethnically diverse than any previously examined, higher plasma NGAL was independently associated with increases in all-cause death, CV death, and nonfatal CV events. This is the first report of an association between NGAL and incident stroke and suggests broad implications in the biology of NGAL and CV disease.
Author Disclosures: H.M. Hall: None. J. Joseph: None. C.R. Ayers: None. A. Rohatgi: None. A. Pandey: None. J.D. Berry: None. J.A. de Lemos: Consultant/Advisory Board; Modest; Roche Diagnostics, Abbott Diagnostics. Research Grant; Significant; Abbott Diagnostics. Consultant/Advisory Board; Significant; Simen’s Health Care, Radiometer. S.R. Das: None.
- © 2016 by American Heart Association, Inc.