Serum neutrophil gelatinase-associated lipocalin concentration reflects severity of coronary artery disease in patients without heart failure and chronic kidney disease

Abstract

Serum neutrophil gelatinase-associated lipocalin (NGAL) is recognized as a useful biomarker for acute kidney injury. Recently, elevated NGAL levels were reported in patients with heart failure and cardiac events, but the association between serum NGAL and severity of coronary artery disease (CAD) has not been investigated adequately. This study aimed to evaluate the association between serum NGAL concentration and CAD severity in patients without heart failure and chronic kidney disease. Two-hundred thirteen patients [mean age: 66.2 ± 9.2 (SD)] without heart failure and chronic kidney disease (estimated glomerular filtration rate >60 mL/min/1.73 m(2)) who underwent coronary angiography were retrospectively analyzed using the SYNTAX score. The mean concentration of serum NGAL was 134.3 ± 111.3 ng/mL. A statistically significant correlation was observed between serum NGAL levels and the SYNTAX score (R = 0.18, P = 0.0091). Multivariable analysis also showed elevated serum NGAL as an independent risk factor for a high SYNTAX score (P < 0.01). Moreover, we evaluated the association of serum NGAL and brain natriuretic peptide (BNP) with the SYNTAX score. Patients with high levels of serum NGAL (>100 ng/mL) and high levels of BNP (>25 pg/mL) had a higher SYNTAX score (low-low vs. high-high: 13.8 ± 13.4 vs. 20.8 ± 18.9, P < 0.05). Serum NGAL levels were positively and significantly associated with CAD severity, and the evaluation of both serum NGAL and BNP was useful for predicting CAD in patients without renal dysfunction and heart failure. Serum NGAL might be a biomarker for CAD severity.

Measuring non‐polyaminated lipocalin‐2 for cardiometabolic risk assessment

“…In fact, urinary and plasma lipocalin‐2 levels are positively associated with increased N‐terminal pro‐brain natriuretic peptide, the New York Heart Association class, and the left ventricular internal end‐diastolic dimension in patients with chronic heart failure . Plasma lipocalin‐2 levels correlate with heart failure severity and predict major adverse cardiovascular events in critically ill patients . The present study demonstrates that npLcn2 represents a more specific marker for cardio‐renal metabolic syndrome.…”

Neutrophil Gelatinase-Associated Lipocalin (NGAL) is Associated with Symptomatic Carotid Atherosclerosis and Drives Pro-inflammatory State In Vitro

“…12 Clinical studies have demonstrated that levels of circulating NGAL are associated with the degree of inflammatory process in patients with coronary artery disease where NGAL levels are higher in patients with acute coronary syndrome compared with patients with stable coronary artery disease, and elevated serum NGAL as an independent risk factor for a high SYNTAX score. 19,20,27 Furthermore, high plasma NGAL levels are associated with poor prognosis in patients with myocardial infarction and in the general population. 16e18 The present study examined the relationship between NGAL mRNA expression in plaque and the percentage of carotid artery stenosis and did not find any significant difference in NGAL mRNA expression in patients with stenosis grade of <90% and !90%.…”

More than a simple biomarker: the role of NGAL in cardiovascular and renal diseases

“…These high levels of NGAL may be explained in part by the renal failure observed in a large number of HF patients (79). However, several studies have showed that NGAL was a predictor of CV incident even in the absence of renal dysfunction (80)(81)(82).…”