Plasma neutrophil gelatinase-associated lipocalin levels are associated with the presence and severity of coronary heart disease

Abstract

Objective This study aimed to compare the levels of plasma neutrophil gelatinase-associated lipocalin (NGAL), matrix metalloproteinase (MMP)-9, high-sensitivity C-reactive protein (hs-CRP), and interleukin (IL)-1β across different clinical presentations of coronary artery disease and to evaluate the relationship between those biomarkers and the severity of coronary artery lesions in patients without kidney disease. Methods We examined 365 eligible patients who underwent coronary angiography. A total of 124 ST-segment elevation myocardial infarction (STEMI) patients, 117 stable angina pectoris (SAP) patients and 124 patients without atherosclerotic plaques were enrolled in the study. Plasma NGAL, MMP-9, hs-CRP, and IL-1β were measured in all patients using the enzyme-linked immunosorbent assay (ELISA) method. According to the SYNTAX score, the STEMI patients and SAP patients were divided into another set of 2 groups: a high score group (≥ 33, n = 29) and a low score group (<33, n = 212). The relationship between those biomarkers and the severity of coronary stenosis was examined by Spearman correlation analysis; the ability for NGAL to discriminate severe coronary stenosis was examined by receiver operating characteristic (ROC) curve; the influencing factors for the SYNTAX score were determined by logistic regression analysis. Results Plasma NGAL, MMP-9, and hs-CRP levels in STEMI patients were higher than in the SAP patients and control subjects (P<0.05, respectively), and plasma NGAL and hs-CRP levels were significantly higher in the SAP patients than in control subjects (P<0.05, respectively), while plasma IL-1β was similar among the 3 groups (P>0.05, respectively). The SYNTAX score was positively related to NGAL (r = 0.363, P<0.001), MMP-9 (r = 0.377, P<0.001), and hs-CRP (r = 0.163, P<0.011); the SYNTAX score was not related to IL-1β (r = -0.043, P = 0.510). Plasma NGAL was positively related to MMP-9 (r = 0.601, P<0.001) and IL-1β (r = 0.159, P = 0.014). The area under the ROC curve for NGAL discriminating severe coronary stenosis was 0.838 (95% CI: 0.752–0.923, P<0.001), which was greater than that for MMP-9 [0.818, (95% CI: 0.724–0.912, P<0.001)], IL-1β [0.485, (95% CI: 0.369–0.601, P = 0.791)], and hs-CRP [0.607, (95% CI: 0.492–0.722, P = 0.061)]. Multivariate regression analysis showed that plasma NGAL levels were independently related to high SYNTAX scores [OR = 1.109, (95% CI: 1.104–1.114), P<0.001]. Conclusion Plasma NGAL, MMP-9, and hs-CRP levels in STEMI patients were higher than those in the SAP patients and control subjects. NGAL had a better ability to discriminate severe coronary stenosis than MMP-9, IL-1β, and hs-CRP. NGAL may be a novel biomarker to aid in risk stratification in coronary heart disease patients.

Serum Biomarkers of Cardiovascular Remodelling Reflect Extra-Valvular Cardiac Damage in Patients with Severe Aortic Stenosis

“…These variants are overexpressed in crucial steps of embryonic cardiovascular development, are virtually absent in healthy adult organs, and are abundantly re-expressed in a wide range of cardiovascular diseases [20][21][22][23][24]28,32,33]. NGAL, classically known as a biomarker of renal failure, could be evidenced as a useful circulating reflector of cardiovascular inflammation, including atherosclerosis development [17,34]. In accordance, we could show significantly elevated levels in AS patients compared to controls.…”

Pcsk9 is associated with severity of coronary artery lesions in male patients with premature myocardial infarction

“…LDL-C, ApoB and SYNTAX scores were significantly positively correlated, which is also consistent with previous research [ 36 ]. However, studies have shown that hs-Crp also correlates positively with CHD severity [ 37 ], which does not agree with results in the present study for patients with PMI. According to these findings, it suggests that severe coronary lesions in various types of CAD (e.g., ST-segment elevation myocardial infarction, stable angina pectoris) may be associated with different predictors.…”

Neutrophil degranulation and myocardial infarction

“…Plasma NGAL levels are significantly higher in STEMI patients than in the stable angina pectoris patients and control subjects [ 85 ]. Multivariate regression analysis presented that NGAL levels were independently correlated to SYNTAX scores [ 85 ]. Plasma NGAL showed a better ability in discriminating severe coronary disease than MMP-9, hs-CRP, and IL-1β [ 85 ].…”