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Guray U, Çöteli C, Korkmaz A, Gulkan B, Kösem A, Türker Duyuler P, Ucar Elalmis O. Value of point-of-care neutrophil gelatinase associated lipocalin in early diagnosis of acute kidney injury in patients with left ventricular systolic dysfunction after coronary angiography. Scandinavian Journal of Clinical and Laboratory Investigation 2021; 81:552-556. [PMID: 34528836 DOI: 10.1080/00365513.2021.1974538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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.
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Affiliation(s)
- Umit Guray
- Department of Cardiology, Ankara City Hospital, Ankara, Turkey
| | - Cem Çöteli
- Department of Cardiology, Ankara City Hospital, Ankara, Turkey
| | - Ahmet Korkmaz
- Department of Cardiology, Ankara City Hospital, Ankara, Turkey
| | - Birsen Gulkan
- Department of Cardiology, Ankara City Hospital, Ankara, Turkey
| | - Arzu Kösem
- Clinical Biochemistry, Ankara City Hospital, Ankara, Turkey
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Tsigkou V, Siasos G, Bletsa E, Panoilia ME, Papastavrou A, Kokosias G, Oikonomou E, Papageorgiou N, Zaromitidou M, Marinos G, Vavuranakis M, Stefanadis C, Papavassiliou AG, Tousoulis D. The Predictive Role for ST2 in Patients with Acute Coronary Syndromes and Heart Failure. Curr Med Chem 2020; 27:4479-4493. [DOI: 10.2174/0929867326666191016121630] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 09/06/2019] [Accepted: 10/04/2019] [Indexed: 12/17/2022]
Abstract
Intensive research has shed light on the utilization of novel biomarkers which facilitate
the diagnosis and prognosis of patients with different medical problems. One of the
most important biomarkers especially in the spectrum of heart failure is soluble ST2 (sST2:
soluble Suppression of Tumorigenicity 2), which is involved in inflammation, fibrosis and
cardiac stress. In the revised 2017 ACC/AHA/HFSA, “Focused Update Guidelines for the
Management of Heart Failure” ST2 was given a class-IIa recommendation for the optimal
risk assessment in patients with heart failure. Many studies indicate that not only baseline but
also serial measurements of ST2 can accurately predict future cardiovascular events in patients
with Acute Coronary Syndromes and heart failure. Therefore, in this review, we are
going to discuss the studies about the prognostic significance of ST2 in patients with Acute
Coronary Syndromes, acute and chronic heart failure.
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Affiliation(s)
- Vasiliki Tsigkou
- Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Gerasimos Siasos
- Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Evanthia Bletsa
- Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Maria-Evi Panoilia
- Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Angeliki Papastavrou
- Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Georgios Kokosias
- Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Evangelos Oikonomou
- Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Nikolaos Papageorgiou
- Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Marina Zaromitidou
- Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Georgios Marinos
- Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Manolis Vavuranakis
- Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | | | - Athanasios G. Papavassiliou
- Department of Biological Chemistry, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Dimitris Tousoulis
- Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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Abstract
Heart failure (HF) is the end result of many different cardiac and non-cardiac abnormalities leading to a complex clinical entity. In this view, the use of biomarkers in HF should be deeply reconsidered; indeed, the same biomarker may carry a different significance in patients with preserved or reduced EF. The aim of this review is to reconsider the role of biomarkers in HF, based on the different clinical characteristics of this syndrome. The role of cardiac and non-cardiac biomarkers will be reviewed with respect of the different clinical manifestations of this syndrome.
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Oikonomou E, Tsalamandris S, Karlis D, Siasos G, Chrysohoou C, Vogiatzi G, Dimitropoulos S, Charalambous G, Kouskouni E, Tousoulis D. The association among biomarkers of renal and heart function in patients with heart failure: the role of NGAL. Biomark Med 2018; 12:1323-1330. [PMID: 30511581 DOI: 10.2217/bmm-2018-0100] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
AIM The NGAL is a biomarker of renal injury associated with the progression of heart failure (HF). We examine the association of NGAL with galectin-3 in patients with chronic HF. METHODS We consecutively enrolled 115 subjects with stable ischemic HF of reduced ejection fraction. Serum levels of galectin-3, b-type natriuretic peptide and NGAL were measured. RESULTS NGAL levels were positively correlated with galectin-3 (rho = 0.26; p = 0.04) and b-type natriuretic peptide levels (rho = 0.30; p = 0.005) and inversely correlated with ejection fraction (rho = -0.31; p = 0.02) and creatinine clearance levels. The NGAL was independently associated with galectin-3 levels. CONCLUSION A positive correlation between NGAL and galectin-3 in HF patients was found, revealing a potential association between renal injury and myocardial fibrosis and remodeling in HF.
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Affiliation(s)
- Evangelos Oikonomou
- First Department of Cardiology, Hippokration Hospital, National & Kapodistrian University of Athens Medical School, Athens, Greece
| | - Sotiris Tsalamandris
- First Department of Cardiology, Hippokration Hospital, National & Kapodistrian University of Athens Medical School, Athens, Greece
| | - Dimitris Karlis
- First Department of Cardiology, Hippokration Hospital, National & Kapodistrian University of Athens Medical School, Athens, Greece
| | - Gerasimos Siasos
- First Department of Cardiology, Hippokration Hospital, National & Kapodistrian University of Athens Medical School, Athens, Greece
| | - Christina Chrysohoou
- First Department of Cardiology, Hippokration Hospital, National & Kapodistrian University of Athens Medical School, Athens, Greece
| | - Georgia Vogiatzi
- First Department of Cardiology, Hippokration Hospital, National & Kapodistrian University of Athens Medical School, Athens, Greece
| | - Stathis Dimitropoulos
- First Department of Cardiology, Hippokration Hospital, National & Kapodistrian University of Athens Medical School, Athens, Greece
| | - Georgios Charalambous
- First Department of Cardiology, Hippokration Hospital, National & Kapodistrian University of Athens Medical School, Athens, Greece
| | - Evangelia Kouskouni
- First Department of Cardiology, Hippokration Hospital, National & Kapodistrian University of Athens Medical School, Athens, Greece
| | - Dimitris Tousoulis
- First Department of Cardiology, Hippokration Hospital, National & Kapodistrian University of Athens Medical School, Athens, Greece
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Renal function assessment in heart failure. Rev Clin Esp 2017; 217:267-288. [PMID: 28258719 DOI: 10.1016/j.rce.2017.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 12/17/2016] [Accepted: 01/14/2017] [Indexed: 11/23/2022]
Abstract
Renal function is one of the most consistent prognostic determinants in heart failure. The prognostic information it provides is independent of the ejection fraction and functional status. This article reviews the various renal function assessment measures, with special emphasis on the fact that the patient's clinical situation and response to the heart failure treatment should be considered for the correct interpretation of the results. Finally, we review the literature on the performance of tubular damage biomarkers.
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Argan O, Ural D, Kozdag G, Sahin T, Bozyel S, Aktas M, Karauzum K, Yilmaz I, Dervis E, Agir A. Associations Between Neutrophil Gelatinase Associated Lipocalin, Neutrophil-to-Lymphocyte Ratio, Atrial Fibrillation and Renal Dysfunction in Chronic Heart Failure. Med Sci Monit 2016; 22:4765-4772. [PMID: 27918494 PMCID: PMC5154709 DOI: 10.12659/msm.898608] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Atrial fibrillation (AF) and renal dysfunction are two common comorbidities in patients with chronic heart failure with reduced ejection fraction (HFrEF). This study evaluated the effect of permanent AF on renal function in HFrEF and investigated the associations of atrial fibrillation, neutrophil gelatinase-associated lipocalin (NGAL), and neutrophil-to-lymphocyte ratio (NLR) with adverse clinical outcome. MATERIAL AND METHODS Serum NGAL levels measured by ELISA and NLR were compared between patients with sinus rhythm (HFrEF-SR, n=68), with permanent AF (HFrEF-AF, n=62), and a healthy control group (n=50). RESULTS Mean eGFR levels were significantly lower, and NLR and NGAL levels were significantly higher in the HFrEF patients than in the control patients but the difference between HFrEF-SR and HFrEF-AF was not statistically significant (NGAL: 95 ng/mL in HFrEF-SR, 113 ng/mL in HFrEF-AF and 84 ng/mL in the control group; p<0.001). Independent associates of baseline eGFR were age, hemoglobin, NLR, triiodothyronine, and pulmonary artery systolic pressure. In a mean 16 months follow-up, adverse clinical outcome defined as progression of kidney dysfunction and composite of all-cause mortality and re-hospitalization were not different between HFrEF-SR and HFrEF-AF patients. Although NGAL was associated with clinical endpoints in the univariate analysis, Cox regression analysis showed that independent predictors of increased events were the presence of signs right heart failure, C-reactive protein, NLR, triiodothyronine, and hemoglobin. In ROC analysis, a NLR >3 had a 68% sensitivity and 75% specificity to predict progression of kidney disease (AUC=0.72, 95% CI 0.58-0.85, p=0.001). CONCLUSIONS Presence of AF in patients with HFrEF was not an independent contributor of adverse clinical outcome (i.e., all-cause death, re-hospitalization) or progression of renal dysfunction. Renal dysfunction in HFrEF was associated with both NLR and NGAL levels, but systemic inflammation reflected by NLR seemed to be a more important determinant of progression of kidney dysfunction.
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Affiliation(s)
- Onur Argan
- Department of Cardiology, Kocaeli State Hospital, Kocaeli, Turkey
| | - Dilek Ural
- Department of Cardiology, Koc University, School of Medicine, Istanbul, Turkey
| | - Guliz Kozdag
- Department of Cardiology, Kocaeli University, Medical Faculty, Kocaeli, Turkey
| | - Tayfun Sahin
- Department of Cardiology, Kocaeli University, Medical Faculty, Kocaeli, Turkey
| | - Serdar Bozyel
- Department of Cardiology, Derince Training and Research Hospital, Kocaeli, Turkey
| | - Mujdat Aktas
- Department of Cardiology, Kocaeli University, Medical Faculty, Kocaeli, Turkey
| | - Kurtulus Karauzum
- Department of Cardiology, Derince Training and Research Hospital, Kocaeli, Turkey
| | - Irem Yilmaz
- Department of Cardiology, Isparta Yalvac State Hospital, Isparta, Turkey
| | - Emir Dervis
- Department of Cardiology, Kocaeli University, Medical Faculty, Kocaeli, Turkey
| | - Aysen Agir
- Department of Cardiology, Kocaeli University, Medical Faculty, Kocaeli, Turkey
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