Российский кардиологический журнал (Jun 2015)

ROLE OF THE SERUM NGAL FOR ASSESSMENT OF HOSPITAL PROGNOSIS IN MEN WITH ST ELEVATION MYOCARDIAL INFARCTION

  • V. N. Karetnikova,
  • A. V. Osokina,
  • M. V. Evseeva,
  • O. V. Gruzdeva,
  • M. V. Zykov,
  • V. V. Kalaeva,
  • V. V. Kashtalap,
  • K. S. Shafranskaya,
  • O N. hryachkova,
  • O. L. Barbarash

DOI
https://doi.org/10.15829/1560-4071-2015-6-61-67
Journal volume & issue
Vol. 0, no. 6
pp. 61 – 67

Abstract

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Aim. To evaluate clinical significance of serum NGAL in ST elevation myocardial infarction (STEMI) patients in relation with the occurrence of in-hospital period complications.Material and methods. Totally 260 men included with STEMI, hospitalized in 24 hours after the onset of clinical symptoms of the disease. The measurement of serum NGAL concentration (ng/ml, sNGAL) at 1st and 2nd day of hospitalization was done with the hard-phase immune-enzyme analysis by Hycult® biotech assay (USA), registration was done on the plain reader “UNIPLAN” (SPF “PIKON”, Russia). At the stage of in-hospital treatment we registrated endpoints — signs of coronary failure (early post infarction angina, recurrent MI), grade of acute coronary failure (Killip I-IV class), grade of chronic heart failure (by NYHA), hospital mortality.Results. Patients were selected into 2 groups depending on the endpoints occurrence at hospital stage. Adverse hospital outcome (at least one endpoint) was found in 83 (32%) patients. The level of renal damage sNGAL, measured on the 1st day did not reveal any difference between groups with adverse or benign course of MI in hospital, and on 12th day the sNGAL concentration was significantly higher in group with adverse course — 2,1 ng/ml (1,44; 2,8) vs 1,55 ng/ml (1,11; 2,3), p=0,033. Monofactor analysis showed significance for adverse outcome, the factors as 2nd type diabetes, age >60 y., the fact of glomerular filtration rate decline during hospitalization, increase of sNGAL by 12th day. By the result of multifactor analysis — increase of the age by 1 year increases the chance of adverse outcome by 14%, increase of sNGAL by 12th day of MI increases adverse outcome chance by 3,2 times. the level of sNGAL ≥1,046 ng/ml associated with complicated course of in-hospital MI period.Conclusion. The level of sNGAL, measured on 1st day of MI did not have prognostic value for the inhospital complications, however concentration of sNGAL on 12th day was associated with already occured adverse outcomes, being a marker of MI severity.

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