BACKGROUND AND OBJECTIVES: The early identification of acute heart failure (HF) patients with type 1 cardio-renal syndrome should be the first step for developing prevention and treatment strategies for these patients. This study aimed to assess the performance of neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C in the early detection of type 1 cardio-renal syndrome in patients with acute HF. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: One-hundred nineteen patients admitted with acute HF were studied. NGAL and creatinine were measured in the first hospitalization morning; creatinine was also measured at least after 48 to 72 hours. Physicians were blinded to NGAL and cystatin C levels. Type 1 cardio-renal syndrome was defined as an increase in the creatinine level of at least 0.3 mg/dl or 50% of basal creatinine. RESULTS: Type 1 cardio-renal syndrome developed within 48 to 72 hours in 14 patients (11.8%). Admission NGAL levels were higher in these patients: 212 versus 83 ng/dl. At a cutoff value of 170 ng/L, NGAL determined type 1 cardio-renal syndrome with a sensitivity of 100% and a specificity of 86.7%. The area under the receiver-operating characteristic curve of NGAL was 0.93 and that of cystatin C was 0.68. CONCLUSIONS: Above a cutoff value of 170 ng/L, NGAL predicts 48- to 72-hour development of type 1 cardio-renal syndrome with a negative predictive value of 100% and a positive predictive value of 50%. NGAL independently associates with type 1 cardio-renal syndrome and might be a useful biomarker in the early recognition of these patients.
BACKGROUND AND OBJECTIVES: The early identification of acute heart failure (HF) patients with type 1 cardio-renal syndrome should be the first step for developing prevention and treatment strategies for these patients. This study aimed to assess the performance of neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C in the early detection of type 1 cardio-renal syndrome in patients with acute HF. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: One-hundred nineteen patients admitted with acute HF were studied. NGAL and creatinine were measured in the first hospitalization morning; creatinine was also measured at least after 48 to 72 hours. Physicians were blinded to NGAL and cystatin C levels. Type 1 cardio-renal syndrome was defined as an increase in the creatinine level of at least 0.3 mg/dl or 50% of basal creatinine. RESULTS: Type 1 cardio-renal syndrome developed within 48 to 72 hours in 14 patients (11.8%). Admission NGAL levels were higher in these patients: 212 versus 83 ng/dl. At a cutoff value of 170 ng/L, NGAL determined type 1 cardio-renal syndrome with a sensitivity of 100% and a specificity of 86.7%. The area under the receiver-operating characteristic curve of NGAL was 0.93 and that of cystatin C was 0.68. CONCLUSIONS: Above a cutoff value of 170 ng/L, NGAL predicts 48- to 72-hour development of type 1 cardio-renal syndrome with a negative predictive value of 100% and a positive predictive value of 50%. NGAL independently associates with type 1 cardio-renal syndrome and might be a useful biomarker in the early recognition of these patients.
Authors: Wilfried Mullens; Zuheir Abrahams; Gary S Francis; George Sokos; David O Taylor; Randall C Starling; James B Young; W H Wilson Tang Journal: J Am Coll Cardiol Date: 2009-02-17 Impact factor: 24.094
Authors: Michael Bennett; Catherine L Dent; Qing Ma; Sudha Dastrala; Frank Grenier; Ryan Workman; Hina Syed; Salman Ali; Jonathan Barasch; Prasad Devarajan Journal: Clin J Am Soc Nephrol Date: 2008-03-12 Impact factor: 8.237
Authors: H Bachorzewska-Gajewska; J Malyszko; E Sitniewska; J S Malyszko; B Poniatowski; K Pawlak; S Dobrzycki Journal: Int J Cardiol Date: 2007-06-13 Impact factor: 4.164
Authors: Thomas L Nickolas; Matthew J O'Rourke; Jun Yang; Meghan E Sise; Pietro A Canetta; Nicholas Barasch; Charles Buchen; Faris Khan; Kiyoshi Mori; James Giglio; Prasad Devarajan; Jonathan Barasch Journal: Ann Intern Med Date: 2008-06-03 Impact factor: 25.391
Authors: Anja Haase-Fielitz; Rinaldo Bellomo; Prasad Devarajan; David Story; George Matalanis; Duska Dragun; Michael Haase Journal: Crit Care Med Date: 2009-02 Impact factor: 7.598
Authors: Catherine L Dent; Qing Ma; Sudha Dastrala; Michael Bennett; Mark M Mitsnefes; Jonathan Barasch; Prasad Devarajan Journal: Crit Care Date: 2007 Impact factor: 9.097
Authors: Navaid Iqbal; Bailey Wentworth; Rajiv Choudhary; Alejandro De La Parra Landa; Benjamin Kipper; Arrash Fard; Alan S Maisel Journal: Cardiovasc Diagn Ther Date: 2012-06
Authors: Bo Yang; Pengcheng Fan; Aimin Xu; Karen Sl Lam; Thorsten Berger; Tak W Mak; Hung-Fat Tse; Jessie Ws Yue; Erfei Song; Paul M Vanhoutte; Gary Sweeney; Yu Wang Journal: Am J Transl Res Date: 2012-01-05 Impact factor: 4.060