J Korean Soc Emerg Med.  2016 Oct;27(5):482-487. 10.0000/jksem.2016.27.5.482.

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

• Kang DH
• Kim SI
• Park JB
• Chung HJ
• Lee YJ
• Park S
• Cho YS

• KMID: 2358290
• DOI: http://doi.org/10.0000/jksem.2016.27.5.482

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.

Keyword

Heart failure; Neurtiophil Gelatinase-Associated Lipocalin (NGAL); Prognosis

MeSH Terms

Cardiopulmonary Resuscitation
Coronary Angiography
Creatine Kinase
Creatinine
Diabetes Mellitus
Emergencies*
Emergency Service, Hospital*
Extracorporeal Membrane Oxygenation
Filtration
Heart Failure*
Heart*
Humans
Incidence
Intensive Care Units
Intra-Aortic Balloon Pumping
Intubation
Lipocalins*
Logistic Models
Natriuretic Peptide, Brain
Neutrophils
Patient Selection
Plasma
Prognosis*
Renal Replacement Therapy
Retrospective Studies
Creatine Kinase
Creatinine
Lipocalins
Natriuretic Peptide, Brain