Plasma Neutrophil Gelatinase-Associated Lipocalin Levels Are Associated With The Presence And Severity Of Coronary Heart Disease

Objective: This study aim to compare the levels of plasma neutrophil gelatinase-associated lipocalin(NGAL),matrix metalloproteinase(MMP)-9,high-sensitivity C-reactive protein(hsCRP)and interleukin(IL)-1? across the different clinical pictures of the coronary heart disease and to evaluation the relationship between those biomarkers with the severity of coronary artery lesions in patients without kidney disease.Methods: The study population consisted 365 eligible patients who underwent coronary angiography.124 ST-segment elevation myocardial infarction(STEMI)patients,117 stable angina pectoris(SAP)patients and 124 patients without atherosclerotic plaques were enrolled in the study.Plasma NGAL,MMP-9?hs-CRP?IL-1? was measured in all patients with enzymelinked immunosorbent assay method.Then the STEMI patients and SAP patients were divided into 2 groups according to SYNTAX score,High score group(?33,n=29),and Low score group(<33,n=212).The relationship between those biomarkers with the severity of coronary artery lesions tested by Spearman correlation analysis,receiver operating characteristic curve and multivariate regression analysis respectively.Results: Plasma NGAL,MMP-9,hs-CRP level in STEMI patients was higher than SAP and Control group(P<0.05,respectively),And,plasma NGAL and hs-CRP levels were significantly higher in the SAP group than control subjects(P< 0.05,respectively).Plasma IL-1? was similar among the groups(P> 0.05,respectively).The SYNTAX score was positively related to NGAL(r=0.363,P=0.000),MMP-9(r=0.377,P=0.000)and hs-CRP(r=0.163,P<0.011);the SYNTAX score was not positively related to IL-1?(r=-0.043,P=0.510).Plasma NGAL was positively correlation with MMP-9(r=0.601,P=0.000)and IL-1?(r=0.159,P=0.014).The area under the curve(AUC)for the plasma NGAL level indicated a strong discriminatory power(AUC=0.838,95% Cl : 0.752-0.923,and P=0.000)than MMP-9(AUC=0.818,95% Cl : 0.724-0.912,and P=0.000),IL-1?(AUC=0.485,95% Cl : 0.369-0.601,and P=0.791)and hs-CRP(AUC=0.607,95% Cl : 0.492-0.722,and P=0.061)for predicting a high SYNTAX score.Multivariate regression analysis presents that the plasma NGAL level was independent to related to high SYNTAX score(OR=1.109,95%Cl:1.104-1.114;P=0.000).Conclusion: Plasma NGAL,MMP-9,hs-CRP level in STEMI patients was higher than SAP and control group,Plasma NGAL level was positively related to MMP-9,IL-1? level and severity of coronary stenosis.NGAL had better ability for discriminating severe coronary stenosis than MMP-9 and hs-CRP.NGAL as a new biomarker should be helpful for risk stratification in coronary heart disease.