Relationship Between Plasma Level of Neutrophil Gelatinase-associated lipocalin and Coronary Lesion Severity in Patients With Acute ST-elevation Myocardial Infarction / 中国循环杂志

ABSTRACT

Objective: To study the relationship between plasma levels of Neutrophil gelatinase- associated lipocalin (NGAL), matrix metalloproteinase (MMP-9), hs-CRP, IL-1β and the severity of coronary stenosis in acute ST-elevation myocardial infarction (STEMI) patients without kidney disease; to explore the ability for NGAL discriminating severe coronary stenosis. Methods: Our research included in 2 groups STEMI group, n=124 patients admitted in our hospital from 2014-01 to 2017-03 and Control group, n=124 subjects without obvious coronary stenosis. According to SYNTAX score, the patients were divided into another set of 2 groups High score group, patients with SYNTAX score ≥ 33, n=26 and Low score group, patients with SYNTAX score < 33, n = 98. Relationship between plasma levels of NGAL, MMP-9, hs-CRP, IL-1β and the severity of coronary stenosis were studied by Spearman correlation analysis; the ability for NGAL discriminating severe coronary stenosis was examined by ORC curve; the influencing factors for SYNTAX score were determined by Logistic regression analysis. Results: Compared with Control group, STEMI group had increased plasma levels of NGAL, MMP-9, hs-CRP, all P < 0.01,while IL-1β was similar between 2 groups, P=0.272. NGAL was positively related to MMP-9 (r=0.757, P<0.01), SYNTAX score (r=0.616, P<0.01) and IL-1β (r=0.185, P<0.05). Compared with Low score group, High score group showed the higher plasma levels of NGAL, MMP-9, both P<0.01, while the lower LVEF, P<0.01. The area under ROC curve for NGAL discriminating severe coronary stenosis was 0.881 (95% Cl 0.813-0.949, P<0.01) which was greater than MMP-9 [0.799 (95% Cl 0.709-0.890, P<0.01)] and hs-CRP [0.446 (95% Cl 0.306-0.587, P=0.400)]. Multivariate regression analysis presented that plasma NGAL level was independently related to high SYNTAX score [OR=1.115, 95% Cl (1.107-1.123), P<0.01]. Conclusion: STEMI patients had increased plasma levels of NGAL, MMP-9 and hs-CRP; NGAL had better ability for discriminating severe coronary stenosis than MMP-9 and hs-CRP. NGAL as a new biomarker should be helpful for risk stratification in STEMI patients.