Neutrophil gelatinase-associated lipocalin (NGAL) is a glycoprotein released by renal tubular cells and considered an early marker of tubular damage.

Neutrophil gelatinase-associated lipocalin (NGAL) is a glycoprotein released by renal tubular cells and considered an early marker of tubular damage. We aimed to evaluate possible utilization of plasma NGAL levels for the identification of acute kidney injury (AKI) among ST segment elevation myocardial infarction (STEMI) patients undergoing primary coronary intervention (PCI).

Methods: We prospectively included 131 patients with STEMI treated with PCI. Blood samples for plasma NGAL were drawn before PCI (NGAL 0 and 24 hours after PCI .AKI was defined using the KDIGO criteria as an increase in serum creatinine of ≥0.3 mg/dl within 48 hours following PCI. Receiver-operator characteristic methods were used to identify the optimal sensitivity and specificity for the observed range of NGAL.

Results: The overall incidence of AKI was 14%. The NGAL levels were significantly higher among patients with AKI both at 0 (164 ± 42 vs. 95 ± 30; p <0.001) and at 24 hours (142 ± 41 vs. 93 ± 36; p <0.001). According to the ROC curve analysis, the optimal cutoff value of 0 NGAL 0 to predict AKI was measured as more than 120 ng/ml, with 80% sensitivity and 80% specificity (AUC 0.881 95% CI 0.801-0.961, p<0.001, figure 1). In a multivariate logistic regression model NGAL level was independently associated with AKI both at 0 hours (OR 1.044, 95% CI 1.013-1.076; P=0.005) and 24 hours (OR 1.018, 95% CI 1.001-1.036; P=0.04)

Conclusions: Elevated NGAL levels suggesting renal tubular damage are independently associated with AKI in STEMI patients undergoing primary PCI.