Prognostic utility of neutrophil gelatinase-associated lipocalin (NGAL) levels for cardiovascular events in patients with stable coronary artery disease treated with percutaneous coronary intervention: a prospective longitudinal cohort study
Abstract Introduction Neutrophil gelatinase-associated lipocalin (NGAL) modulates the enzymatic activity of matrix metalloproteinase-9, which is an important mediator of plaque instability in atherosclerosis. High NGAL levels can independently predict all-cause mortality and major adverse cardiac ev...
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BMC
2025-02-01
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| Series: | Biomarker Research |
| Online Access: | https://doi.org/10.1186/s40364-025-00737-7 |
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| author | Ting-Yu Lin Hsin-Bang Leu Yen-Wen Wu Wei-Kung Tseng Tsung-Hsien Lin Hung-I Yeh Kuan-Cheng Chang Ji-Hung Wang Wei-Hsian Yin Chau-Chung Wu Chun-Yao Huang Shing-Jong Lin Chien-Yi Hsu Jaw-Wen Chen |
| author_facet | Ting-Yu Lin Hsin-Bang Leu Yen-Wen Wu Wei-Kung Tseng Tsung-Hsien Lin Hung-I Yeh Kuan-Cheng Chang Ji-Hung Wang Wei-Hsian Yin Chau-Chung Wu Chun-Yao Huang Shing-Jong Lin Chien-Yi Hsu Jaw-Wen Chen |
| author_sort | Ting-Yu Lin |
| collection | DOAJ |
| description | Abstract Introduction Neutrophil gelatinase-associated lipocalin (NGAL) modulates the enzymatic activity of matrix metalloproteinase-9, which is an important mediator of plaque instability in atherosclerosis. High NGAL levels can independently predict all-cause mortality and major adverse cardiac events (MACE) in patients with acute myocardial infarction (AMI). However, studies that have measured NGAL levels in patients with stable coronary artery disease (CAD) are limited. Furthermore, no significant prognostic predictive value between NGAL levels and stable CAD has been established. Hypothesis We aimed to investigate the prognostic role of NGAL levels in a prospective cohort study of patients with stable CAD treated with percutaneous coronary intervention (PCI). Methods A total of 2,238 stable patients with CAD and a previous PCI were enrolled in a multicenter prospective observational study (The National Taiwan Biosignature Research, NTBR) in Taiwan. The primary outcome was the occurrence of MACE (cardiovascular death, nonfatal myocardial infarction, and ischemic stroke). The secondary outcome was a composite of cardiovascular events (cardiovascular death, nonfatal MI, nonfatal stroke, and hospitalization for heart failure). Results During the mean follow-up period of 4.6 ± 1.7 years, 441 patients reached the primary endpoints. Kaplan-Meier analysis showed that event-free survival was significantly different between the first and third tertile groups (log-rank test, p < 0.001) in subjects categorized by NGAL levels. In a multivariate Cox proportional hazard regression analysis, plasma NGAL levels were independently associated with an increased risk of MACE [adjusted hazard ratio (aHR) = 1.35; 95% confidence interval (CI) = 1.18–1.54, p < 0.001], AMI (aHR = 1.34; 95% CI = 1.12–1.59, p < 0.001), and target vessel revascularization (aHR = 1.35; 95% CI = 1.19–1.53, p < 0.001). Addition of serum NGAL levels to the traditional risk model improved its prediction value for future cardiovascular events. Conclusions High plasma NGAL levels were independently associated with the occurrence of MACE and composite cardiovascular events in patients with stable PCI-treat CAD. |
| format | Article |
| id | doaj-art-c7cf980987f5410fa67404a8c990fd2c |
| institution | Kabale University |
| issn | 2050-7771 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
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| series | Biomarker Research |
| spelling | doaj-art-c7cf980987f5410fa67404a8c990fd2c2025-02-09T12:48:23ZengBMCBiomarker Research2050-77712025-02-0113111310.1186/s40364-025-00737-7Prognostic utility of neutrophil gelatinase-associated lipocalin (NGAL) levels for cardiovascular events in patients with stable coronary artery disease treated with percutaneous coronary intervention: a prospective longitudinal cohort studyTing-Yu Lin0Hsin-Bang Leu1Yen-Wen Wu2Wei-Kung Tseng3Tsung-Hsien Lin4Hung-I Yeh5Kuan-Cheng Chang6Ji-Hung Wang7Wei-Hsian Yin8Chau-Chung Wu9Chun-Yao Huang10Shing-Jong Lin11Chien-Yi Hsu12Jaw-Wen Chen13School of Medicine, National Yang Ming Chiao Tung UniversitySchool of Medicine, National Yang Ming Chiao Tung UniversitySchool of Medicine, National Yang Ming Chiao Tung UniversityDivision of Cardiology, Department of Internal Medicine, E-Da HospitalDivision of Cardiology, Department of Internal Medicine, Faculty of Medicine, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityDivision of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, MacKay Medical CollegeDivision of Cardiovascular Medicine, Department of Medicine, China Medical University HospitalDepartment of Cardiology, Buddhist Tzu-Chi General Hospital, Tzu-Chi UniversityHeart Center, Faculty of Medicine, School of Medicine, Cheng Hsin General Hospital, National Yang Ming Chiao Tung UniversityCardiology Division, Department of Internal Medicine, Graduate Institute of Medical Education and Bioethics, College of Medicine, National Taiwan University Hospital, National Taiwan UniversityDivision of Cardiology and Cardiovascular Research Center, Department of Internal Medicine, Taipei Medical University HospitalDivision of Cardiology and Cardiovascular Research Center, Department of Internal Medicine, Taipei Medical University HospitalDivision of Cardiology and Cardiovascular Research Center, Department of Internal Medicine, Taipei Medical University HospitalDivision of Cardiology and Cardiovascular Research Center, Department of Internal Medicine, Taipei Medical University HospitalAbstract Introduction Neutrophil gelatinase-associated lipocalin (NGAL) modulates the enzymatic activity of matrix metalloproteinase-9, which is an important mediator of plaque instability in atherosclerosis. High NGAL levels can independently predict all-cause mortality and major adverse cardiac events (MACE) in patients with acute myocardial infarction (AMI). However, studies that have measured NGAL levels in patients with stable coronary artery disease (CAD) are limited. Furthermore, no significant prognostic predictive value between NGAL levels and stable CAD has been established. Hypothesis We aimed to investigate the prognostic role of NGAL levels in a prospective cohort study of patients with stable CAD treated with percutaneous coronary intervention (PCI). Methods A total of 2,238 stable patients with CAD and a previous PCI were enrolled in a multicenter prospective observational study (The National Taiwan Biosignature Research, NTBR) in Taiwan. The primary outcome was the occurrence of MACE (cardiovascular death, nonfatal myocardial infarction, and ischemic stroke). The secondary outcome was a composite of cardiovascular events (cardiovascular death, nonfatal MI, nonfatal stroke, and hospitalization for heart failure). Results During the mean follow-up period of 4.6 ± 1.7 years, 441 patients reached the primary endpoints. Kaplan-Meier analysis showed that event-free survival was significantly different between the first and third tertile groups (log-rank test, p < 0.001) in subjects categorized by NGAL levels. In a multivariate Cox proportional hazard regression analysis, plasma NGAL levels were independently associated with an increased risk of MACE [adjusted hazard ratio (aHR) = 1.35; 95% confidence interval (CI) = 1.18–1.54, p < 0.001], AMI (aHR = 1.34; 95% CI = 1.12–1.59, p < 0.001), and target vessel revascularization (aHR = 1.35; 95% CI = 1.19–1.53, p < 0.001). Addition of serum NGAL levels to the traditional risk model improved its prediction value for future cardiovascular events. Conclusions High plasma NGAL levels were independently associated with the occurrence of MACE and composite cardiovascular events in patients with stable PCI-treat CAD.https://doi.org/10.1186/s40364-025-00737-7 |
| spellingShingle | Ting-Yu Lin Hsin-Bang Leu Yen-Wen Wu Wei-Kung Tseng Tsung-Hsien Lin Hung-I Yeh Kuan-Cheng Chang Ji-Hung Wang Wei-Hsian Yin Chau-Chung Wu Chun-Yao Huang Shing-Jong Lin Chien-Yi Hsu Jaw-Wen Chen Prognostic utility of neutrophil gelatinase-associated lipocalin (NGAL) levels for cardiovascular events in patients with stable coronary artery disease treated with percutaneous coronary intervention: a prospective longitudinal cohort study Biomarker Research |
| title | Prognostic utility of neutrophil gelatinase-associated lipocalin (NGAL) levels for cardiovascular events in patients with stable coronary artery disease treated with percutaneous coronary intervention: a prospective longitudinal cohort study |
| title_full | Prognostic utility of neutrophil gelatinase-associated lipocalin (NGAL) levels for cardiovascular events in patients with stable coronary artery disease treated with percutaneous coronary intervention: a prospective longitudinal cohort study |
| title_fullStr | Prognostic utility of neutrophil gelatinase-associated lipocalin (NGAL) levels for cardiovascular events in patients with stable coronary artery disease treated with percutaneous coronary intervention: a prospective longitudinal cohort study |
| title_full_unstemmed | Prognostic utility of neutrophil gelatinase-associated lipocalin (NGAL) levels for cardiovascular events in patients with stable coronary artery disease treated with percutaneous coronary intervention: a prospective longitudinal cohort study |
| title_short | Prognostic utility of neutrophil gelatinase-associated lipocalin (NGAL) levels for cardiovascular events in patients with stable coronary artery disease treated with percutaneous coronary intervention: a prospective longitudinal cohort study |
| title_sort | prognostic utility of neutrophil gelatinase associated lipocalin ngal levels for cardiovascular events in patients with stable coronary artery disease treated with percutaneous coronary intervention a prospective longitudinal cohort study |
| url | https://doi.org/10.1186/s40364-025-00737-7 |
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