PDF(Pubmed)
Abstract：
UNASSIGNED: The diagnosis of acute kidney injury (AKI) is of importance among patients with ST segment elevation (STEMI) undergoing primary coronary intervention (PCI). It is often delayed given the need in serial measurements of creatinine or other serum markers. Neutrophil gelatinase-associated lipocalin (NGAL) is a proven marker for AKI, although its role as an early predictor in this setting was scarcely addressed before and was the aim of our study.
UNASSIGNED: Prospective observational study including 133 patients with STEMI treated with PCI. Plasma NGAL was drawn immediately before PCI (NGAL-0) and 24 h after (NGAL-24). Similar analysis of C-reactive protein (CRP) was performed for additional comparison.
UNASSIGNED: Mean age was 62 ± 13 years, 78% were men, and 20 (15%) developed AKI after admission. Patients with AKI after admission demonstrated higher levels of NGAL-0 (164 vs. 95 ng/mL; p < 0.001) and NGAL-24 (142 vs. 93 ng/mL; p < 0.001). Levels of NGAL-0 and NGAL-24 were similar within the AKI and non-AKI groups. Using ROC curve analysis, NGAL-0 had best predictive ability for AKI development (AUC 0.841, 95% CI 0.80-0.96), compared with NGAL-24 (0.783, 95% CI 0.74-0.85), CRP-0 (0.701, 95% CI 0.58-0.83), and CRP-24 (0.781, 95% CI 0.66-0.90). The optimal NGAL-0 cutoff for AKI prediction was 125 ng/mL, with 70% sensitivity, 84% specificity, and 94% negative predictive value.
UNASSIGNED: Among STEMI patients, NGAL measurement upon admission are associated with AKI and may serve as a reliable marker for early AKI detection. Future studies may direct risk stratification using this single test can direct personalized evaluations during the admission, and focused interventions to prevent AKI.
UNASSIGNED: Prospective observational study including 133 patients with STEMI treated with PCI. Plasma NGAL was drawn immediately before PCI (NGAL-0) and 24 h after (NGAL-24). Similar analysis of C-reactive protein (CRP) was performed for additional comparison.
UNASSIGNED: Mean age was 62 ± 13 years, 78% were men, and 20 (15%) developed AKI after admission. Patients with AKI after admission demonstrated higher levels of NGAL-0 (164 vs. 95 ng/mL; p < 0.001) and NGAL-24 (142 vs. 93 ng/mL; p < 0.001). Levels of NGAL-0 and NGAL-24 were similar within the AKI and non-AKI groups. Using ROC curve analysis, NGAL-0 had best predictive ability for AKI development (AUC 0.841, 95% CI 0.80-0.96), compared with NGAL-24 (0.783, 95% CI 0.74-0.85), CRP-0 (0.701, 95% CI 0.58-0.83), and CRP-24 (0.781, 95% CI 0.66-0.90). The optimal NGAL-0 cutoff for AKI prediction was 125 ng/mL, with 70% sensitivity, 84% specificity, and 94% negative predictive value.
UNASSIGNED: Among STEMI patients, NGAL measurement upon admission are associated with AKI and may serve as a reliable marker for early AKI detection. Future studies may direct risk stratification using this single test can direct personalized evaluations during the admission, and focused interventions to prevent AKI.
摘要：
■急性肾损伤（AKI）的诊断在接受直接冠状动脉介入治疗（PCI）的ST段抬高（STEMI）患者中很重要。由于需要对肌酐或其他血清标志物进行连续测量，因此通常会延迟。中性粒细胞明胶酶相关脂质运载蛋白（NGAL）是AKI的公认标志物，尽管它在这种情况下作为早期预测因子的作用以前几乎没有得到讨论，这是我们研究的目的。
■前瞻性观察性研究，包括133例接受PCI治疗的STEMI患者。在PCI前(NGAL-0)和术后24小时(NGAL-24)抽取血浆NGAL。进行C-反应蛋白(CRP)的类似分析用于另外的比较。
■平均年龄为62±13岁，78%是男性,20例（15%）患者入院后发生AKI。入院后AKI患者NGAL-0水平较高（164vs.95ng/mL；p<0.001）和NGAL-24（142vs.93ng/mL；p<0.001)。NGAL-0和NGAL-24的水平在AKI和非AKI组中相似。采用ROC曲线分析,NGAL-0对AKI发展具有最佳预测能力（AUC0.841，95％CI0.80-0.96），与NGAL-24相比（0.783，95%CI0.74-0.85），CRP-0（0.701，95%CI0.58-0.83），和CRP-24（0.781，95%CI0.66-0.90）。预测AKI的最佳NGAL-0截止值为125ng/mL，70%的灵敏度,84%的特异性，和94%的阴性预测值。
■在STEMI患者中，入院时的NGAL测量与AKI相关，可以作为早期AKI检测的可靠标志物。未来的研究可能会使用这种单一测试直接进行风险分层，可以在入院期间进行个性化评估，以及预防AKI的重点干预措施。
■前瞻性观察性研究，包括133例接受PCI治疗的STEMI患者。在PCI前(NGAL-0)和术后24小时(NGAL-24)抽取血浆NGAL。进行C-反应蛋白(CRP)的类似分析用于另外的比较。
■平均年龄为62±13岁，78%是男性,20例（15%）患者入院后发生AKI。入院后AKI患者NGAL-0水平较高（164vs.95ng/mL；p<0.001）和NGAL-24（142vs.93ng/mL；p<0.001)。NGAL-0和NGAL-24的水平在AKI和非AKI组中相似。采用ROC曲线分析,NGAL-0对AKI发展具有最佳预测能力（AUC0.841，95％CI0.80-0.96），与NGAL-24相比（0.783，95%CI0.74-0.85），CRP-0（0.701，95%CI0.58-0.83），和CRP-24（0.781，95%CI0.66-0.90）。预测AKI的最佳NGAL-0截止值为125ng/mL，70%的灵敏度,84%的特异性，和94%的阴性预测值。
■在STEMI患者中，入院时的NGAL测量与AKI相关，可以作为早期AKI检测的可靠标志物。未来的研究可能会使用这种单一测试直接进行风险分层，可以在入院期间进行个性化评估，以及预防AKI的重点干预措施。
