Neutrophil gelatinase-associated lipocalin (NGAL) is a measure of acute kidney injury. Renal dysfunction portends significant risk after discharge from acute heart failure (AHF). Thus, a sensitive marker of renal injury might also help to risk stratify HF patients

Aghel

Alan S. Maisel

Brian C. Hiestand

Butler

Cheng

Chertow

Christian Mueller

Damman

DeLong

Dent

Devarajan

Dirk J. van Veldhuisen

Dries

Haase

Heywood

Hirsch

Januzzi

Kazanegra

Krumholz

Maisel

McAlister

McCullough

Metra

Mishra

Mori

Navaid Iqbal

Paul Clopton

Pencina

Robert Brikhan

Robert Fitzgerald

Rogers

Schmidt-Ott

Shlipak

Smilde

Smith

Weinfeld

English

PubMed

Aims Neutrophil gelatinase-associated lipocalin (NGAL) is a measure of acute kidney injury. Renal dysfunction portends significant risk after discharge from acute heart failure (AHF). Thus, a sensitive marker of renal injury might also help to risk stratify HF patients.Methods and results GALLANT [NGAL EvaLuation Along with B-type NaTriuretic Peptide (BNP) in acutely Decompensated Heart Failure] was a multicentre, prospective study to assess the utility of plasma NGAL, alone and in combination with BNP, as an early risk marker of adverse outcomes. We studied 186 patients (61% male). There were 29 events (AHF readmissions and all-cause mortality) at 30 days (16%). Patients with events had higher levels of NGAL than those without (134 vs. 84 ng/mL, P &lt;0.001). The area under the receiver operating characteristic curve was higher for NGAL (0.72) than BNP (0.65), serum creatinine (0.57), or estimated glomerular filtration rate (eGFR; 0.55). In multivariable analyses, NGAL predicted events (P = 0.001), BNP approached significance (P = 0.052 and 0.070 without creatinine and GFR, respectively) while neither serum creatinine nor eGFR were significant. The addition of discharge NGAL over BNP alone improved classification by a net 10.3% in those with events and 19.5% in those without events, for a net reclassification improvement of 29.8% (P = 0.010). Subjects with both BNP and NGAL elevated were at significant risk [hazard ratio (HR) = 16.85, P = 0.006], as were subjects with low BNP and high NGAL (HR = 9.95, P = 0.036).Conclusions Plasma NGAL is a measure of kidney injury that at the time of discharge is a strong prognostic indicator of 30 days outcomes in patients admitted for AHF.</p

Maisel, Alan S.

Mueller, Christian

Fitzgerald, Robert

Brikhan, Robert

Hiestand, Brian C.

Iqbal, Navaid

Clopton, Paul

van Veldhuisen, Dirk J.

ARTS repository - University of Groningen

Prognostic utility of plasma neutrophil gelatinase-associated lipocalin in patients with acute heart failure:The NGAL EvaLuation Along with B-type NaTriuretic Peptide in acutely decompensated heart failure (GALLANT) trial

Dissertations of the University of Groningen

Proceedings - University of Groningen

Aims Neutrophil gelatinase-associated lipocalin (NGAL) is a measure of acute kidney injury. Renal dysfunction portends significant risk after discharge from acute heart failure (AHF). Thus, a sensitive marker of renal injury might also help to risk stratify HF patients. Methods and results GALLANT [NGAL EvaLuation Along with B-type NaTriuretic Peptide (BNP) in acutely Decompensated Heart Failure] was a multicentre, prospective study to assess the utility of plasma NGAL, alone and in combination with BNP, as an early risk marker of adverse outcomes. We studied 186 patients (61% male). There were 29 events (AHF readmissions and all-cause mortality) at 30 days (16%). Patients with events had higher levels of NGAL than those without (134 vs. 84 ng/mL, P <0.001). The area under the receiver operating characteristic curve was higher for NGAL (0.72) than BNP (0.65), serum creatinine (0.57), or estimated glomerular filtration rate (eGFR; 0.55). In multivariable analyses, NGAL predicted events (P = 0.001), BNP approached significance (P = 0.052 and 0.070 without creatinine and GFR, respectively) while neither serum creatinine nor eGFR were significant. The addition of discharge NGAL over BNP alone improved classification by a net 10.3% in those with events and 19.5% in those without events, for a net reclassification improvement of 29.8% (P = 0.010). Subjects with both BNP and NGAL elevated were at significant risk [hazard ratio (HR) = 16.85, P = 0.006], as were subjects with low BNP and high NGAL (HR = 9.95, P = 0.036). Conclusions Plasma NGAL is a measure of kidney injury that at the time of discharge is a strong prognostic indicator of 30 days outcomes in patients admitted for AHF

NARCIS 

Prognostic utility of plasma neutrophil gelatinase-associated lipocalin in patients with acute heart failure: The NGAL EvaLuation Along with B-type NaTriuretic Peptide in acutely decompensated heart failure (GALLANT) trial

University of Groningen

edoc

Prognostic utility of plasma neutrophil gelatinase-associated lipocalin in patients with acute heart failure : the NGAL EvaLuation Along with B-type NaTriuretic Peptide in acutely decompensated heart failure (GALLANT) trial

Crossref

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Prognostic utility of plasma neutrophil gelatinase‐associated lipocalin in patients with acute heart failure: The NGAL EvaLuation Along with B‐type NaTriuretic Peptide in acutely decompensated heart failure (GALLANT) trial

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Prognostic utility of plasma neutrophil gelatinase-associated lipocalin in patients with acute heart failure: The NGAL EvaLuation Along with B-type NaTriuretic Peptide in acutely decompensated heart failure (GALLANT) trial

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ARTS repository - University of Groningen

Dissertations of the University of Groningen

Proceedings - University of Groningen

NARCIS

University of Groningen

ARTS repository - University of Groningen

edoc

Proceedings - University of Groningen

Crossref