Serum neutrophil gelatinase-associated lipocalin has an advantage over serum cystatin C and glomerular filtration rate in prediction of adverse cardiovascular outcome in patients with ST-segment elevation myocardial infarction.

BACKGROUND: The aim of this study was to assess significance of serum neutrophil gelatinase-associated lipocalin (sNGAL) and cystatin C (sCC) in prediction of adverse cardiovascular outcome after ST-segment elevation myocardial infarction (STEMI). METHODS: We recruited 357 consecutive patients who were admitted to the hospital within 24 h after onset of STEMI. On the 1st and 12th-14th day after hospital admission, we measured levels of sNGAL and sCC. We also determined presence of renal dysfunction (RD), defined as glomerular filtration rate < 60 mL/min/1.73 m2. After 3 years of follow-up, we performed a logistic regression and assessed the value of RD, sNGAL, and sCC in prediction of combined endpoint, defined as cardiovascular death or any cardiovascular complication. RESULTS: RD, sCC level ≥ 1.9 mg/L, and sNGAL level ≥ 1.25 ng/mL on the 12th-14th day of hospitalization were associated with a 1.6-fold, 1.9-fold, and 2.9-fold higher risk of adverse cardiovascular outcome, respectively. Area under the ROC curve was the highest for the model based on sNGAL level compared to the models based on sCC level or RD presence. CONCLUSIONS: Measurement of sNGAL level in patients with STEMI on the 12th-14th day after hospital admission may improve prediction of adverse cardiovascular outcome.

Interleukin-12 serum level has prognostic value in patients with ST-segment elevation myocardial infarction.

OBJECTIVES: The study aimed to evaluate whether serum inflammatory markers have prognostic value in patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND: The role of cytokine-driven inflammation in the development of postdischarge complications after STEMI is obscured. METHODS: We recruited 214 patients who were admitted within 24 h of STEMI onset to our Institute. IL-1α, -6, -8, -10, -12, TNF-α, and CRP serum levels were measured on the 10-14th day after STEMI onset. RESULTS: Serum levels of IL-12, TNF-α, and CRP were significantly higher in patients with 3 affected coronary arteries compared to those with 1 affected coronary artery. However, only Killip class II-IV at admission and IL-12 serum level ≥90.0 pg/mL were defined as statistically significant predictors of adverse outcome after 1 year of follow-up. CONCLUSION: IL-12 serum level may be suggested as a candidate prognostic marker if measured 10-14 days after STEMI onset.

The prognostic value of peripheral artery diseases in patients with ST-segment elevation myocardial infarction.

HYPOTHESIS: To evaluate the clinical and prognostic role of haemodynamically insignificant stenosis of the extracranial arteries (ECA) and lower extremity arteries (LEA) among patients with ST-segment elevation myocardial infarction (STEMI). PATIENTS AND METHODS: The study sample consisted of 423 patients with STEMI who were consecutively admitted to the Kemerovo Cardiological Centre. RESULTS: The prevalence of polyvascular diseases (PVD), as defined by an increased intima-media thickness (IMT) of the common carotid artery or by stenosis of the ECA or LEA, was 95%. Among patients with ECA or LEA, the case fatality rate of those with stenosis with occlusion of less than 30% of the vessel lumen was 5.7%, whereas the case fatality rate among patients with stenosis with occlusion of more than 30% of the vessel lumen was 15.1% (χ(2) = 13.68, P = 0.003). Using the GRACE score model, together with the determination of additional factors (congestive heart failure, PVD, prior stroke, and smoking status), we developed an improved model (KemScore) for death risk stratification for a 12-month period. The value of the AUC for our model (KemScore) was 0.83 (95% CI = 0.76-0.90), which was significantly higher than the initial GRACE score value of 0.71 (95% CI = 0.63-0.79).