Prognostic value of neutrophil gelatinase-associated lipocalin and cystatin C in patients with heart failure and previous myocardial infarction

Abstract

Aim. To study the prognostic value of neutrophil gelatinase-associated lipocalin (NGAL or lipocalin-2) and cystatin C in patients with heart failure (HF) and myocardial infarction (MI).Material and methods. Baseline plasma concentrations of NGAL and cystatin C were measured in 119 participants (median age, 50-61 years; men, 101) with HF and primary MI (4-6 weeks old) who underwent percutaneous coronary intervention in the acute period. Adverse cardiovascular events within 1 year were considered as the endpoint.Results. Patients with elevated NGAL levels were significantly more likely to have adverse events (p<0,001). The optimal cut-off value for NGAL was 18,75 ng/ml (odds ratio, 10, 95% CI, 3,09-32,45; p=0,0001). Multivariate logistic regression showed that NGAL, N-terminal pro-brain natriuretic peptide, left ventricular aneurysm, and SYNTAX score were significant predictors of adverse events. Cystatin C did not affect prognosis in the study cohort.Conclusion. Increased NGAL levels is a predictor of unfavorable clinical outcome in patients with HF and previous MI.

Keywords

• heart failure
• prognosis
• biomarkers
• lipocalin-2
• cystatin c