HELÁNOVÁ, Kateřina, Simona LITTNEROVÁ, Petr KUBENA, Eva GANOVSKÁ, Marie PAVLUŠOVÁ, Lenka KUBKOVÁ, Jiří JARKOVSKÝ, Monika PÁVKOVÁ GOLDBERGOVÁ, Jolana LIPKOVÁ, Jana GOTTWALDOVÁ, Petr KALA, Ondřej TOMAN, Milan DASTYCH, Jindřich ŠPINAR and Jiří PAŘENICA. Prognostic impact of neutrophil gelatinase-associated lipocalin and B-type natriuretic in patients with ST-elevation myocardial infarction treated by primary PCI: a prospective observational cohort study. BMJ Open. London: BMJ Publishing Group, 2015, vol. 5, No 10, p. "e006872", 8 pp. ISSN 2044-6055. Available from: https://dx.doi.org/10.1136/bmjopen-2014-006872.
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Basic information
Original name Prognostic impact of neutrophil gelatinase-associated lipocalin and B-type natriuretic in patients with ST-elevation myocardial infarction treated by primary PCI: a prospective observational cohort study
Authors HELÁNOVÁ, Kateřina (203 Czech Republic, guarantor, belonging to the institution), Simona LITTNEROVÁ (203 Czech Republic, belonging to the institution), Petr KUBENA (203 Czech Republic, belonging to the institution), Eva GANOVSKÁ (703 Slovakia, belonging to the institution), Marie PAVLUŠOVÁ (203 Czech Republic, belonging to the institution), Lenka KUBKOVÁ (203 Czech Republic, belonging to the institution), Jiří JARKOVSKÝ (203 Czech Republic, belonging to the institution), Monika PÁVKOVÁ GOLDBERGOVÁ (203 Czech Republic, belonging to the institution), Jolana LIPKOVÁ (203 Czech Republic, belonging to the institution), Jana GOTTWALDOVÁ (203 Czech Republic, belonging to the institution), Petr KALA (203 Czech Republic, belonging to the institution), Ondřej TOMAN (203 Czech Republic), Milan DASTYCH (203 Czech Republic, belonging to the institution), Jindřich ŠPINAR (203 Czech Republic, belonging to the institution) and Jiří PAŘENICA (203 Czech Republic, belonging to the institution).
Edition BMJ Open, London, BMJ Publishing Group, 2015, 2044-6055.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30201 Cardiac and Cardiovascular systems
Country of publisher United Kingdom of Great Britain and Northern Ireland
Confidentiality degree is not subject to a state or trade secret
Impact factor Impact factor: 2.562
RIV identification code RIV/00216224:14110/15:00085266
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1136/bmjopen-2014-006872
UT WoS 000365467600002
Keywords in English brain natriuretic peptide; neutrophil gelatinase associated lipocalin
Tags EL OK
Tags International impact, Reviewed
Changed by Changed by: Soňa Böhmová, učo 232884. Changed: 28/4/2016 14:27.
Abstract
Objectives: Neutrophil gelatinase-associated lipocalin (NGAL) from a pathophysiological perspective connects various pathways that affect the prognosis after myocardial infarction. The objective was to evaluate the benefits of measuring NGAL for prognostic stratification in addition to the Thrombolysis in Myocardial Infarction (TIMI) score, and to compare it with the prognostic value of B-type natriuretic peptide (BNP). Design: Prospective observational cohort study. Setting: One university/tertiary centre. Participants: A total of 673 patients with ST segment elevation myocardial infarction were treated by primary percutaneous coronary intervention. NGAL and BNP were assessed on hospital admission. Outcomes: Primary outcome: 1-year mortality. Secondary outcomes: 1-year hospitalisation due to acute heart failure, unplanned revascularisation, reinfarction, stroke and combined end point of 1-year mortality and hospitalisation due to heart failure. Statistical methods: Using the c-statistic, the ability of NGAL, BNP and TIMI score to predict 1-year mortality alone and in combination with readmission for heart failure was evaluated. The addition of the predictive value of biomarkers to the score was assessed by category free net reclassification improvement (cfNRI) and the integrated discrimination index (IDI). Results: The NGAL level was significantly higher in non-survivors (67 vs 115 pg/mL; p<0.001). The area under the curve (AUC) values for mortality prediction for NGAL, BNP and TIMI score were 75.5, 78.7 and 74.4, respectively (all p<0.001) with optimal cut-off values of 84 pg/mL for NGAL and 150 pg/mL for BNP. The addition of NGAL and BNP to the TIMI score significantly improved risk stratification according to cfNRI and IDI. A BNP and the combination of the TIMI score with NGAL predicted the occurrence of the combined end point with an AUC of 80.6 or 82.2, respectively. NGAL alone is a simple tool to identify very high-risk patients. NGAL >110 pg/mL was associated with a 1-year mortality of 20%. Conclusions: The measurement of NGAL together with the TIMI score results in a strong prognostic model for the 1-year mortality rate in patients with STEMI.
Links
MUNI/A/1544/2014, interní kód MUName: Prediktory rehospitalizace a mortality u pacientů hospitalizovaných pro akutní srdeční selhání
Investor: Masaryk University, Category A
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