Abstract

Background: Increased neutrophil gelatinase-associated lipocalin (NGAL) levels are associated with toxic or ischemic renal injury. Objective: This study aimed to assess the usefulness of serial NGAL measurements with a point-of-care assay in patients with left ventricular systolic dysfunction (LVSD) for earlier detection of contrast-induced nephropathy (CIN). Materials and methods: A total of 84 patients with LVSD patients referred for coronary angiography were consecutively enrolled in the study. The study population was divided into two groups as the CIN and the non-CIN groups according to the CIN's determination. The serum creatinine levels were calculated 24 h before the procedure and at the 48th and 72nd h after the cardiac catheterization. The plasma NGAL concentration was measured before and at 4 and 24 h after the cardiac catheterization. Results: Baseline and serial NGAL levels were significantly higher in patients with CIN compared to the patients without CIN. NGAL 24th h levels after the index procedure were found to be an independent and significant predictor of CIN in multivariate analysis. Conclusions: Serial point-of-care NGAL measurements might help earlier detection of CIN in patients with heart failure after coronary angiography.

摘要

背景：中性粒细胞明胶酶相关载脂蛋白 (NGAL) 水平升高与中毒性或缺血性肾损伤有关。目的：本研究旨在评估在左心室收缩功能障碍 (LVSD) 患者中使用即时检测的连续 NGAL 测量对早期发现造影剂肾病 (CIN) 的有用性。材料和方法：共有 84 名 LVSD 患者被转诊进行冠状动脉造影，连续纳入研究。根据 CIN 的确定，将研究人群分为 CIN 组和非 CIN 组两组。术前 24 小时和心导管插入术后 48 小时和 72 小时计算血清肌酐水平。在心导管插入术之前和之后 4 和 24 小时测量血浆 NGAL 浓度。结果：与没有 CIN 的患者相比，CIN 患者的基线和系列 NGAL 水平显着升高。在多变量分析中发现，指数程序后 24 小时的 NGAL 水平是 CIN 的独立且显着的预测因子。结论：连续护理点 NGAL 测量可能有助于在冠状动脉造影后早期检测心力衰竭患者的 CIN。