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This study investigated the prognostic value of neutrophil gelatinase-associated lipocalin (NGAL) in patients with ST-segment elevation myocardial infarction (STEMI).Neutrophil gelatinase-associated lipocalin is a promising biomarker for acute kidney injury. Recently, it was concluded that NGAL may be used beyond the boundaries of renal physiopathology. It was found to be an important factor indirectly contributing to the inflammatory processes. Little is known regarding its predictive role in STEMI.One hundred six consecutive patients who underwent percutaneous coronary intervention (PCI) for STEMI and control group consisted of age- and sex-matched 60 consecutive patients with chest pain admitted to the hospital for elective PCI. According to median NGAL level, patients were classified into high- and low-NGAL groups.Neutrophil gelatinase-associated lipocalin levels were higher in patients with STEMI compared to the elective PCI group subjects. Inhospital and 1-year mortality rates were found to be significantly greater in patients with high NGAL. In addition, inhospital and 1-year major adverse cardiovascular event rates were significantly greater in the high-NGAL group, compared to the low NGAL group. High NGAL level on admission was a significant predictor for long-term mortality and major adverse cardiovascular events. The receiver operating characteristics curve analysis further illustrated that NGAL level on admission is a strong indicator of mortality, with an area under the curve of 0.76 (95% confidence interval, 0.62-0.89).High NGAL levels may be associated with poor prognosis after PCI in patients with STEMI. However, further studies with larger numbers of patients and longer follow-up are required to evaluate the usefulness of plasma NGAL level for predicting prognosis of STEMI. [ABSTRACT FROM AUTHOR]

Serum uric acid (SUA) is associated with microvascular disease that could alter coronary blood flow and prognosis. We evaluated the effects of admission SUA levels on coronary blood flow and prognosis in 185 consecutive patients with ST-segment elevation myocardial infarction (STEMI) who underwent acute primary percutaneous coronary intervention (PCI).Patients undergoing PCI for an acute STEMI were stratified into elevated SUA (>6.5 mg/dL) and normal SUA group (≤6.5 mg/dL). Primary end points were post-PCI myocardial blood flow and in-hospital and 1-year mortality.Serum uric acid level was high in 45 patients (24%) on admission. Subjects with elevated SUA had a higher prevalence of hypertension, previous myocardial infarction, multivessel disease, and Killip functional class III or higher. Corrected thrombolysis in myocardial infarction (TIMI) frame count was longer, and mean TIMI myocardial perfusion grade was higher in patients with elevated uric acid compared with controls. Patients with elevated SUA levels had higher in-hospital (6.6% vs 2.8%, P < 0.01) and 1-year mortality (11.1% vs 5.7%, P < 0.01). Major adverse cardiac events were higher in patients with elevated SUA levels both in-hospital (11.1% vs 5.7%, P < 0.01) and at 1 year (17.7% vs 10%, P < 0.05). An elevated admission SUA level also independently predicted both 1-year mortality (odds ratio, 1.41; 95% confidence interval, 1.24-2.69) and abnormal myocardial perfusion detected by TIMI myocardial perfusion grade in STEMI patients undergoing primary PCI (odds ratio, 2.14; 95% confidence interval, 1.17-4.19, respectively).Elevated SUA level on admission independently predicts impaired myocardial flow and poor prognosis in STEMI patients undergoing primary PCI. [ABSTRACT FROM AUTHOR]