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.
■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。