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

J 2015

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

HELÁNOVÁ, Kateřina, Simona LITTNEROVÁ, Petr KUBENA, Eva GANOVSKÁ, Marie PAVLUŠOVÁ et. al.

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

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

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

Abstract

V originále

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 MU

Name: Prediktory rehospitalizace a mortality u pacientů hospitalizovaných pro akutní srdeční selhání

Investor: Masaryk University, Category A

Citovat

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.

@article{1321537,
   author = {Helánová, Kateřina and Littnerová, Simona and Kubena, Petr and Ganovská, Eva and Pavlušová, Marie and Kubková, Lenka and Jarkovský, Jiří and Pávková Goldbergová, Monika and Lipková, Jolana and Gottwaldová, Jana and Kala, Petr and Toman, Ondřej and Dastych, Milan and Špinar, Jindřich and Pařenica, Jiří},
   article_location = {London},
   article_number = {10},
   doi = {http://dx.doi.org/10.1136/bmjopen-2014-006872},
   keywords = {brain natriuretic peptide; neutrophil gelatinase associated lipocalin},
   language = {eng},
   issn = {2044-6055},
   journal = {BMJ Open},
   title = {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},
   volume = {5},
   year = {2015}
}

TY  - JOUR
ID  - 1321537
AU  - Helánová, Kateřina - Littnerová, Simona - Kubena, Petr - Ganovská, Eva - Pavlušová, Marie - Kubková, Lenka - Jarkovský, Jiří - Pávková Goldbergová, Monika - Lipková, Jolana - Gottwaldová, Jana - Kala, Petr - Toman, Ondřej - Dastych, Milan - Špinar, Jindřich - Pařenica, Jiří
PY  - 2015
TI  - 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
JF  - BMJ Open
VL  - 5
IS  - 10
SP  - "e006872"
EP  - "e006872"
PB  - BMJ Publishing Group
SN  - 20446055
KW  - brain natriuretic peptide
KW  - neutrophil gelatinase associated lipocalin
N2  - 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.
ER  -

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. \textit{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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