Usefulness of Neurtiophil Gelatinase-Associated Lipocalin as a Prognosis Predictor in Heart Failure Patients in Emergency Department

ABSTRACT

PURPOSE: We aimed to investigate the clinical use of plasma neutrophil gelatinase-associated lipocalin (NGAL) in the emergency department (ED), especially for predicting the prognosis of heart failure. METHODS: In a retrospective study, patient selection was based on those who visited the ED between January 2015 and September 2015 and were diagnosed with heart failure and underwent laboratory tests, including B-type natriuretic peptide (BNP) and NGAL. They were divided in two groups, according to the presence or absence of the following events one or more intubations, admission of intensive care unit (ICU), coronary angiography, renal replacement therapy, extracorporeal membrane oxygenation, intra-aortic balloon pumping, cardiopulmonary resuscitation (CPR), or death. RESULTS: We studied 63 patients with heart failure. The absence group consisted of 29 subjects, and the presence group consisted of 34 subjects. Patients who were younger, had a history of diabetes mellitus, had high level of serum creatinine, low estimated glomerular filtration (eGFR), high creatine kinase (CK) or high NGAL were associated with higher incidence of events and were statistically significant (p<0.001, 0.02, 0.005, 0.035, 0.03, 0.003). In the case of BNP, the presence group showed a higher value compared with the absence group, but was not statistically significant. In a multivariated logistic regression, age (OR=0.868, 95% confidence interval 0.788-0.956, p=0.004) and NGAL (OR=1.004, 95%CI 1.001-1.007, p=0.021) were considered as meaningful factors for predicting the event. CONCLUSION: NGAL elevation in this study showed to be a meaningful factor, indicating a prognosis to those patients who visited the ED and were diagnosed as heart failure.