Plasma neutrophil gelatinase-associated lipocalin and long-term mortality in patients with acute heart failure and normal renal function

Abstract

Neutrophil gelatinase-associated lipocalin (NGAL) has emerged as a renal tubular marker for early renal dysfunction [1]. Recent studies highlighted its role in predicting acute kidney injury (AKI) and clinical outcomes in a wide range of cardiovascular diseases [2], [3], [4] and [5]. However, in heart failure (HF), conflicting results have been reported [4], [5], [6] and [7] and some ambiguities still prevail about the prognostic utility of NGAL beyond standard prognosticators and traditional renal biomarkers. We aimed to evaluate the independent ability of serum NGAL for predicting long-term mortality in patients admitted for acute HF (AHF).

We prospectively enrolled 206 patients consecutively admitted for AHF in the Cardiology Department of a third level centre from April 30th 2010 to March 1st 2011. We excluded patients with a diagnosis of pneumonia, sepsis, acute coronary syndrome or end-stage renal failure on dialysis or imminent need of dialysis. Demographic data, medical history, vital signs, 12-lead electrocardiogram, and laboratory data were determined on admission. Left ventricular ejection fraction (LVEF) was assessed by echocardiography during index hospitalization. Treatment was individualized following established guidelines [8].