Archives of cardiovascular diseases
Volume 112, n° 3
pages 180-186 (mars 2019)
Doi : 10.1016/j.acvd.2018.11.006
Received : 5 June 2018 ;  accepted : 4 November 2018
Cliical research

Evaluation of neutrophil gelatinase-associated lipocalin and cystatin C as biomarkers of acute kidney injury after ST-segment elevation myocardial infarction treated by percutaneous coronary intervention
 

Lee S. Nguyen, Vincent Spagnoli, Mathieu Kerneis, Marie Hauguel-Moreau, Olivier Barthélémy, Jean-Philippe Collet, Gilles Montalescot, Johanne Silvain , 1
 Sorbonne université , ACTION Study group , Institut de Cardiologie (APHP), INSERM UMRS 1166 , hôpital Pitié-Salpêtrière, 75013 Paris, France 

Auteur correspondant.
Summary
Background

Two biomarkers of early acute kidney injuryplasmatic neutrophil gelatinase-associated lipocalin (NGAL) and cystatin Care not used in routine clinical practice in patients with ST-segment elevation myocardial infarction (STEMI) treated by percutaneous coronary intervention (PCI) because of a lack of supporting data.

Aims

To evaluate the predictive value of NGAL and cystatin C regarding the incidence of contrast-induced acute kidney injury (CI-AKI) and clinical outcomes after STEMI in patients treated by primary PCI.

Methods

Plasmatic NGAL and cystatin C were measured on admission, before any contrast exposure, in 701 unselected patients with STEMI. Associations between biomarker concentrations and incidence of CI-AKI (assessed at 48h), haemodialysis requirement at 1 year and all-cause mortality at 1 year were assessed by logistic regression analyses and receiver operating characteristic area under the curve analysis (c -statistic). Discrimination performance comparison was performed using the DeLong test.

Results

NGAL and cystatin C had mild discrimination regarding CI-AKI, with c-statistics of 0.60 (P =0.001) and 0.60 (P =0.002), respectively. Combining NGAL and cystatin C did not improve their discrimination (c -statistic 0.61; P =0.001). There was no significant difference in discrimination between NGAL, cystatin C and baseline creatinine (P =0.57). Regression analyses showed no independent association between NGAL and CI-AKI, haemodialysis or 1-year mortality. Similarly, cystatin C was not associated with these clinical outcomes.

Conclusions

In this cohort of patients with STEMI treated by primary PCI, plasmatic NGAL and cystatin C did not provide additional value regarding CI-AKI prediction compared with known risk factors such as baseline creatinine.

The full text of this article is available in PDF format.

Keywords : STEMI, Primary PCI, Acute kidney injury, Biomarkers, Contrast volume

Abbreviations : AKIN, AMI, CI-AKI, eGFR, ELISA, NGAL, PCI, STEMI, TIMI


1  www.action-coeur.org.


© 2018  Published by Elsevier Masson SAS.