Neutrophil gelatinase-associated lipocalin, cystatin C and eGFR indicate acute kidney injury and predict prognosis of patients with acute pulmonary embolism
ObjectiveRisk stratification in acute pulmonary embolism (APE) includes the assessment of clinical status, right ventricular dysfunction and troponin concentrations. Since acute renal impairment is one of the important predictors of mortality in cardiovascular diseases, the authors hypothesised that...
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| Veröffentlicht in: | Heart (British Cardiac Society) 2012-08, Vol.98 (16), p.1221-1228 |
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| creator | Kostrubiec, Maciej Łabyk, Andrzej Pedowska-Włoszek, Justyna Dzikowska-Diduch, Olga Wojciechowski, Artur Garlińska, Marzena Ciurzyński, Michał Pruszczyk, Piotr |
| description | ObjectiveRisk stratification in acute pulmonary embolism (APE) includes the assessment of clinical status, right ventricular dysfunction and troponin concentrations. Since acute renal impairment is one of the important predictors of mortality in cardiovascular diseases, the authors hypothesised that it is an independent mortality marker in APE.Material and methodsThe authors observed 142 consecutive patients (52 M/90 F, 64±18 years) with APE diagnosed with contrast enhanced multislice CT. On admission, blood samples were collected for neutrophil gelatinase-associated lipocalin (N-GAL), cystatin C and creatinine assays. Estimated glomerular filtration rate (eGFR) was calculated using MDRD formula.ResultsFourteen (10%) of 142 patients died by the 30th day of observation. eGFR≤60 ml/min was noted in 68 (48%) patients and eGFR≤30 ml/min in 11 (8%) patients. eGFR was higher in survivors than in non-survivors (66 (17–169) vs 46 (10–119) ml/min, respectively, p=0.02). In 80 (56%) patients, N-GAL was >50 ng/ml indicating acute kidney injury. N-GAL was higher in non-survivors than in survivors (88.8 (28.4–200.0) vs 53.0 (7.1–200.0) ng/ml, p50 ng/ml was found in 11 (79%) patients with fatal outcome. Area under the curve of N-GAL for all-cause mortality in ROC analysis was 0.715. N-GAL>75 ng/ml was present in 44 (31%) patients, while cystatin C >1900 ng/ml in 14 (10%) subjects. They showed sensitivity, specificity, positive predictive value and negative predictive value for prediction of all-cause death ((64%, 73%, 21%, 95%) and (36%, 91%, 30% 93%), respectively). N-GAL>75 ng/ml and cystatin C>1900 ng/ml increased the risk of death (HR 4.4 (95% CI 1.48 to 13.2, p |
| doi_str_mv | 10.1136/heartjnl-2012-301884 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1027834457</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1027834457</sourcerecordid><originalsourceid>FETCH-LOGICAL-b443t-9fc9b4a1a23aa5be2df34a775972eb1b0ea6e30b66f387057d7b321aec647d143</originalsourceid><addsrcrecordid>eNqNkd1u1DAQhSMEoqXwBghZQkhcEOq_2MklBFqQqgXxJ8SNNUkmXW8TO8SOYN-Fh8XLbovEFTcea-Y7RzM6WfaQ0eeMCXW6Rpjjxg05p4zngrKylLeyYyZVuWt9vZ3-oihyRYU-yu6FsKGUyqpUd7MjzjUtKq6Os18rXOLsp7UdyCUOEK2DgDmE4FsLETsy2Mm3MFj3jLTbEHcEqQm4juD52QdiXWfbBBJol_Re2c7hNnU3y7z9Q00zJiKm6i-dDzYQ35Mp2aCLgfywcX2QTsswegdJhmPjBxvG-9mdHoaADw71JPt89vpT_Sa_eHf-tn5xkTdSiphXfVs1EhhwAVA0yLteSNC6qDTHhjUUQaGgjVK9KNPhutON4AywVVJ3TIqT7OneN-34fcEQzWhDi8MADv0SDKNcl0LKQif08T_oxi-zS9sZpkuqOauYSpTcU-3sQ5ixN9Nsx3RasjK79Mx1emaXntmnl2SPDuZLM2J3I7qOKwFPDgCElEk_g2tt-MspVilZicTle86GiD9v5jBfGaWFLszqS20-1u-FWn17ZV4m_nTPN-Pm_1b9DRtCxk8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1780721916</pqid></control><display><type>article</type><title>Neutrophil gelatinase-associated lipocalin, cystatin C and eGFR indicate acute kidney injury and predict prognosis of patients with acute pulmonary embolism</title><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><source>PubMed Central</source><creator>Kostrubiec, Maciej ; Łabyk, Andrzej ; Pedowska-Włoszek, Justyna ; Dzikowska-Diduch, Olga ; Wojciechowski, Artur ; Garlińska, Marzena ; Ciurzyński, Michał ; Pruszczyk, Piotr</creator><creatorcontrib>Kostrubiec, Maciej ; Łabyk, Andrzej ; Pedowska-Włoszek, Justyna ; Dzikowska-Diduch, Olga ; Wojciechowski, Artur ; Garlińska, Marzena ; Ciurzyński, Michał ; Pruszczyk, Piotr</creatorcontrib><description>ObjectiveRisk stratification in acute pulmonary embolism (APE) includes the assessment of clinical status, right ventricular dysfunction and troponin concentrations. Since acute renal impairment is one of the important predictors of mortality in cardiovascular diseases, the authors hypothesised that it is an independent mortality marker in APE.Material and methodsThe authors observed 142 consecutive patients (52 M/90 F, 64±18 years) with APE diagnosed with contrast enhanced multislice CT. On admission, blood samples were collected for neutrophil gelatinase-associated lipocalin (N-GAL), cystatin C and creatinine assays. Estimated glomerular filtration rate (eGFR) was calculated using MDRD formula.ResultsFourteen (10%) of 142 patients died by the 30th day of observation. eGFR≤60 ml/min was noted in 68 (48%) patients and eGFR≤30 ml/min in 11 (8%) patients. eGFR was higher in survivors than in non-survivors (66 (17–169) vs 46 (10–119) ml/min, respectively, p=0.02). In 80 (56%) patients, N-GAL was >50 ng/ml indicating acute kidney injury. N-GAL was higher in non-survivors than in survivors (88.8 (28.4–200.0) vs 53.0 (7.1–200.0) ng/ml, p<0.01). N-GAL level >50 ng/ml was found in 11 (79%) patients with fatal outcome. Area under the curve of N-GAL for all-cause mortality in ROC analysis was 0.715. N-GAL>75 ng/ml was present in 44 (31%) patients, while cystatin C >1900 ng/ml in 14 (10%) subjects. They showed sensitivity, specificity, positive predictive value and negative predictive value for prediction of all-cause death ((64%, 73%, 21%, 95%) and (36%, 91%, 30% 93%), respectively). N-GAL>75 ng/ml and cystatin C>1900 ng/ml increased the risk of death (HR 4.4 (95% CI 1.48 to 13.2, p<0.01) and 4.7 (95% CI 1.56 to 13.9, p=0.01), respectively).ConclusionsAcute kidney injury assessed by N-GAL occurs in 30% of APE and may contribute to the impairment of renal function present in half of them. Moreover, N-GAL, cystatin C elevation and low eGFR are associated with a poor 30-day prognosis in APE.</description><identifier>ISSN: 1355-6037</identifier><identifier>EISSN: 1468-201X</identifier><identifier>DOI: 10.1136/heartjnl-2012-301884</identifier><identifier>PMID: 22705926</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Cardiovascular Society</publisher><subject>Acute coronary syndromes ; Acute Disease ; Acute Kidney Injury - blood ; Acute Kidney Injury - diagnosis ; Acute Kidney Injury - mortality ; Acute Kidney Injury - physiopathology ; Acute-Phase Proteins ; Aged ; Aged, 80 and over ; allied specialities ; aorta ; aortic valve disease ; Biological and medical sciences ; Biomarkers ; Biomarkers - blood ; Blood platelets ; Cardiology ; Cardiology. Vascular system ; cardiorenal syndrome ; Chi-Square Distribution ; Creatinine - blood ; cystatin C ; Cystatin C - blood ; eGFR ; Embolisms ; Emergency medical care ; emergency medicine ; endothelial function ; endothelium ; Female ; Glomerular Filtration Rate ; great vessels and trauma ; haematology ; Heart failure ; Humans ; Immunoassay ; Kaplan-Meier Estimate ; Kidney - physiopathology ; Kidney diseases ; Kidneys ; Lipocalin-2 ; Lipocalins - blood ; Male ; Medical prognosis ; Medical sciences ; Middle Aged ; mitral stenosis ; Mortality ; Multidetector Computed Tomography ; Multivariate Analysis ; N-GAL ; Nephrology. Urinary tract diseases ; Neutrophils ; Plasma ; Pneumology ; Poland ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Prospective Studies ; Proto-Oncogene Proteins - blood ; pulmonary embolism ; Pulmonary Embolism - diagnosis ; Pulmonary Embolism - diagnostic imaging ; Pulmonary Embolism - mortality ; Pulmonary Embolism - physiopathology ; Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases ; quality of care and outcomes ; renal disease ; Renal failure ; renovascular disease ; Risk Assessment ; Risk Factors ; ROC Curve ; Sensitivity and Specificity ; Time Factors ; Urinary system involvement in other diseases. Miscellaneous ; Urine ; valvular disease ; venous thromboembolism ; Ventricular Function, Right</subject><ispartof>Heart (British Cardiac Society), 2012-08, Vol.98 (16), p.1221-1228</ispartof><rights>2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright: 2012 (c) 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b443t-9fc9b4a1a23aa5be2df34a775972eb1b0ea6e30b66f387057d7b321aec647d143</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://heart.bmj.com/content/98/16/1221.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://heart.bmj.com/content/98/16/1221.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,780,784,3196,23571,27924,27925,77600,77631</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26196493$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22705926$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kostrubiec, Maciej</creatorcontrib><creatorcontrib>Łabyk, Andrzej</creatorcontrib><creatorcontrib>Pedowska-Włoszek, Justyna</creatorcontrib><creatorcontrib>Dzikowska-Diduch, Olga</creatorcontrib><creatorcontrib>Wojciechowski, Artur</creatorcontrib><creatorcontrib>Garlińska, Marzena</creatorcontrib><creatorcontrib>Ciurzyński, Michał</creatorcontrib><creatorcontrib>Pruszczyk, Piotr</creatorcontrib><title>Neutrophil gelatinase-associated lipocalin, cystatin C and eGFR indicate acute kidney injury and predict prognosis of patients with acute pulmonary embolism</title><title>Heart (British Cardiac Society)</title><addtitle>Heart</addtitle><description>ObjectiveRisk stratification in acute pulmonary embolism (APE) includes the assessment of clinical status, right ventricular dysfunction and troponin concentrations. Since acute renal impairment is one of the important predictors of mortality in cardiovascular diseases, the authors hypothesised that it is an independent mortality marker in APE.Material and methodsThe authors observed 142 consecutive patients (52 M/90 F, 64±18 years) with APE diagnosed with contrast enhanced multislice CT. On admission, blood samples were collected for neutrophil gelatinase-associated lipocalin (N-GAL), cystatin C and creatinine assays. Estimated glomerular filtration rate (eGFR) was calculated using MDRD formula.ResultsFourteen (10%) of 142 patients died by the 30th day of observation. eGFR≤60 ml/min was noted in 68 (48%) patients and eGFR≤30 ml/min in 11 (8%) patients. eGFR was higher in survivors than in non-survivors (66 (17–169) vs 46 (10–119) ml/min, respectively, p=0.02). In 80 (56%) patients, N-GAL was >50 ng/ml indicating acute kidney injury. N-GAL was higher in non-survivors than in survivors (88.8 (28.4–200.0) vs 53.0 (7.1–200.0) ng/ml, p<0.01). N-GAL level >50 ng/ml was found in 11 (79%) patients with fatal outcome. Area under the curve of N-GAL for all-cause mortality in ROC analysis was 0.715. N-GAL>75 ng/ml was present in 44 (31%) patients, while cystatin C >1900 ng/ml in 14 (10%) subjects. They showed sensitivity, specificity, positive predictive value and negative predictive value for prediction of all-cause death ((64%, 73%, 21%, 95%) and (36%, 91%, 30% 93%), respectively). N-GAL>75 ng/ml and cystatin C>1900 ng/ml increased the risk of death (HR 4.4 (95% CI 1.48 to 13.2, p<0.01) and 4.7 (95% CI 1.56 to 13.9, p=0.01), respectively).ConclusionsAcute kidney injury assessed by N-GAL occurs in 30% of APE and may contribute to the impairment of renal function present in half of them. Moreover, N-GAL, cystatin C elevation and low eGFR are associated with a poor 30-day prognosis in APE.</description><subject>Acute coronary syndromes</subject><subject>Acute Disease</subject><subject>Acute Kidney Injury - blood</subject><subject>Acute Kidney Injury - diagnosis</subject><subject>Acute Kidney Injury - mortality</subject><subject>Acute Kidney Injury - physiopathology</subject><subject>Acute-Phase Proteins</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>allied specialities</subject><subject>aorta</subject><subject>aortic valve disease</subject><subject>Biological and medical sciences</subject><subject>Biomarkers</subject><subject>Biomarkers - blood</subject><subject>Blood platelets</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>cardiorenal syndrome</subject><subject>Chi-Square Distribution</subject><subject>Creatinine - blood</subject><subject>cystatin C</subject><subject>Cystatin C - blood</subject><subject>eGFR</subject><subject>Embolisms</subject><subject>Emergency medical care</subject><subject>emergency medicine</subject><subject>endothelial function</subject><subject>endothelium</subject><subject>Female</subject><subject>Glomerular Filtration Rate</subject><subject>great vessels and trauma</subject><subject>haematology</subject><subject>Heart failure</subject><subject>Humans</subject><subject>Immunoassay</subject><subject>Kaplan-Meier Estimate</subject><subject>Kidney - physiopathology</subject><subject>Kidney diseases</subject><subject>Kidneys</subject><subject>Lipocalin-2</subject><subject>Lipocalins - blood</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>mitral stenosis</subject><subject>Mortality</subject><subject>Multidetector Computed Tomography</subject><subject>Multivariate Analysis</subject><subject>N-GAL</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Neutrophils</subject><subject>Plasma</subject><subject>Pneumology</subject><subject>Poland</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Proto-Oncogene Proteins - blood</subject><subject>pulmonary embolism</subject><subject>Pulmonary Embolism - diagnosis</subject><subject>Pulmonary Embolism - diagnostic imaging</subject><subject>Pulmonary Embolism - mortality</subject><subject>Pulmonary Embolism - physiopathology</subject><subject>Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases</subject><subject>quality of care and outcomes</subject><subject>renal disease</subject><subject>Renal failure</subject><subject>renovascular disease</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>ROC Curve</subject><subject>Sensitivity and Specificity</subject><subject>Time Factors</subject><subject>Urinary system involvement in other diseases. Miscellaneous</subject><subject>Urine</subject><subject>valvular disease</subject><subject>venous thromboembolism</subject><subject>Ventricular Function, Right</subject><issn>1355-6037</issn><issn>1468-201X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkd1u1DAQhSMEoqXwBghZQkhcEOq_2MklBFqQqgXxJ8SNNUkmXW8TO8SOYN-Fh8XLbovEFTcea-Y7RzM6WfaQ0eeMCXW6Rpjjxg05p4zngrKylLeyYyZVuWt9vZ3-oihyRYU-yu6FsKGUyqpUd7MjzjUtKq6Os18rXOLsp7UdyCUOEK2DgDmE4FsLETsy2Mm3MFj3jLTbEHcEqQm4juD52QdiXWfbBBJol_Re2c7hNnU3y7z9Q00zJiKm6i-dDzYQ35Mp2aCLgfywcX2QTsswegdJhmPjBxvG-9mdHoaADw71JPt89vpT_Sa_eHf-tn5xkTdSiphXfVs1EhhwAVA0yLteSNC6qDTHhjUUQaGgjVK9KNPhutON4AywVVJ3TIqT7OneN-34fcEQzWhDi8MADv0SDKNcl0LKQif08T_oxi-zS9sZpkuqOauYSpTcU-3sQ5ixN9Nsx3RasjK79Mx1emaXntmnl2SPDuZLM2J3I7qOKwFPDgCElEk_g2tt-MspVilZicTle86GiD9v5jBfGaWFLszqS20-1u-FWn17ZV4m_nTPN-Pm_1b9DRtCxk8</recordid><startdate>20120801</startdate><enddate>20120801</enddate><creator>Kostrubiec, Maciej</creator><creator>Łabyk, Andrzej</creator><creator>Pedowska-Włoszek, Justyna</creator><creator>Dzikowska-Diduch, Olga</creator><creator>Wojciechowski, Artur</creator><creator>Garlińska, Marzena</creator><creator>Ciurzyński, Michał</creator><creator>Pruszczyk, Piotr</creator><general>BMJ Publishing Group Ltd and British Cardiovascular Society</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20120801</creationdate><title>Neutrophil gelatinase-associated lipocalin, cystatin C and eGFR indicate acute kidney injury and predict prognosis of patients with acute pulmonary embolism</title><author>Kostrubiec, Maciej ; Łabyk, Andrzej ; Pedowska-Włoszek, Justyna ; Dzikowska-Diduch, Olga ; Wojciechowski, Artur ; Garlińska, Marzena ; Ciurzyński, Michał ; Pruszczyk, Piotr</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b443t-9fc9b4a1a23aa5be2df34a775972eb1b0ea6e30b66f387057d7b321aec647d143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Acute coronary syndromes</topic><topic>Acute Disease</topic><topic>Acute Kidney Injury - blood</topic><topic>Acute Kidney Injury - diagnosis</topic><topic>Acute Kidney Injury - mortality</topic><topic>Acute Kidney Injury - physiopathology</topic><topic>Acute-Phase Proteins</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>allied specialities</topic><topic>aorta</topic><topic>aortic valve disease</topic><topic>Biological and medical sciences</topic><topic>Biomarkers</topic><topic>Biomarkers - blood</topic><topic>Blood platelets</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>cardiorenal syndrome</topic><topic>Chi-Square Distribution</topic><topic>Creatinine - blood</topic><topic>cystatin C</topic><topic>Cystatin C - blood</topic><topic>eGFR</topic><topic>Embolisms</topic><topic>Emergency medical care</topic><topic>emergency medicine</topic><topic>endothelial function</topic><topic>endothelium</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>great vessels and trauma</topic><topic>haematology</topic><topic>Heart failure</topic><topic>Humans</topic><topic>Immunoassay</topic><topic>Kaplan-Meier Estimate</topic><topic>Kidney - physiopathology</topic><topic>Kidney diseases</topic><topic>Kidneys</topic><topic>Lipocalin-2</topic><topic>Lipocalins - blood</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>mitral stenosis</topic><topic>Mortality</topic><topic>Multidetector Computed Tomography</topic><topic>Multivariate Analysis</topic><topic>N-GAL</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Neutrophils</topic><topic>Plasma</topic><topic>Pneumology</topic><topic>Poland</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Proto-Oncogene Proteins - blood</topic><topic>pulmonary embolism</topic><topic>Pulmonary Embolism - diagnosis</topic><topic>Pulmonary Embolism - diagnostic imaging</topic><topic>Pulmonary Embolism - mortality</topic><topic>Pulmonary Embolism - physiopathology</topic><topic>Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases</topic><topic>quality of care and outcomes</topic><topic>renal disease</topic><topic>Renal failure</topic><topic>renovascular disease</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>ROC Curve</topic><topic>Sensitivity and Specificity</topic><topic>Time Factors</topic><topic>Urinary system involvement in other diseases. Miscellaneous</topic><topic>Urine</topic><topic>valvular disease</topic><topic>venous thromboembolism</topic><topic>Ventricular Function, Right</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kostrubiec, Maciej</creatorcontrib><creatorcontrib>Łabyk, Andrzej</creatorcontrib><creatorcontrib>Pedowska-Włoszek, Justyna</creatorcontrib><creatorcontrib>Dzikowska-Diduch, Olga</creatorcontrib><creatorcontrib>Wojciechowski, Artur</creatorcontrib><creatorcontrib>Garlińska, Marzena</creatorcontrib><creatorcontrib>Ciurzyński, Michał</creatorcontrib><creatorcontrib>Pruszczyk, Piotr</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Heart (British Cardiac Society)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kostrubiec, Maciej</au><au>Łabyk, Andrzej</au><au>Pedowska-Włoszek, Justyna</au><au>Dzikowska-Diduch, Olga</au><au>Wojciechowski, Artur</au><au>Garlińska, Marzena</au><au>Ciurzyński, Michał</au><au>Pruszczyk, Piotr</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neutrophil gelatinase-associated lipocalin, cystatin C and eGFR indicate acute kidney injury and predict prognosis of patients with acute pulmonary embolism</atitle><jtitle>Heart (British Cardiac Society)</jtitle><addtitle>Heart</addtitle><date>2012-08-01</date><risdate>2012</risdate><volume>98</volume><issue>16</issue><spage>1221</spage><epage>1228</epage><pages>1221-1228</pages><issn>1355-6037</issn><eissn>1468-201X</eissn><abstract>ObjectiveRisk stratification in acute pulmonary embolism (APE) includes the assessment of clinical status, right ventricular dysfunction and troponin concentrations. Since acute renal impairment is one of the important predictors of mortality in cardiovascular diseases, the authors hypothesised that it is an independent mortality marker in APE.Material and methodsThe authors observed 142 consecutive patients (52 M/90 F, 64±18 years) with APE diagnosed with contrast enhanced multislice CT. On admission, blood samples were collected for neutrophil gelatinase-associated lipocalin (N-GAL), cystatin C and creatinine assays. Estimated glomerular filtration rate (eGFR) was calculated using MDRD formula.ResultsFourteen (10%) of 142 patients died by the 30th day of observation. eGFR≤60 ml/min was noted in 68 (48%) patients and eGFR≤30 ml/min in 11 (8%) patients. eGFR was higher in survivors than in non-survivors (66 (17–169) vs 46 (10–119) ml/min, respectively, p=0.02). In 80 (56%) patients, N-GAL was >50 ng/ml indicating acute kidney injury. N-GAL was higher in non-survivors than in survivors (88.8 (28.4–200.0) vs 53.0 (7.1–200.0) ng/ml, p<0.01). N-GAL level >50 ng/ml was found in 11 (79%) patients with fatal outcome. Area under the curve of N-GAL for all-cause mortality in ROC analysis was 0.715. N-GAL>75 ng/ml was present in 44 (31%) patients, while cystatin C >1900 ng/ml in 14 (10%) subjects. They showed sensitivity, specificity, positive predictive value and negative predictive value for prediction of all-cause death ((64%, 73%, 21%, 95%) and (36%, 91%, 30% 93%), respectively). N-GAL>75 ng/ml and cystatin C>1900 ng/ml increased the risk of death (HR 4.4 (95% CI 1.48 to 13.2, p<0.01) and 4.7 (95% CI 1.56 to 13.9, p=0.01), respectively).ConclusionsAcute kidney injury assessed by N-GAL occurs in 30% of APE and may contribute to the impairment of renal function present in half of them. Moreover, N-GAL, cystatin C elevation and low eGFR are associated with a poor 30-day prognosis in APE.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Cardiovascular Society</pub><pmid>22705926</pmid><doi>10.1136/heartjnl-2012-301884</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1355-6037 |
| ispartof | Heart (British Cardiac Society), 2012-08, Vol.98 (16), p.1221-1228 |
| issn | 1355-6037 1468-201X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1027834457 |
| source | MEDLINE; BMJ Journals - NESLi2; PubMed Central |
| subjects | Acute coronary syndromes Acute Disease Acute Kidney Injury - blood Acute Kidney Injury - diagnosis Acute Kidney Injury - mortality Acute Kidney Injury - physiopathology Acute-Phase Proteins Aged Aged, 80 and over allied specialities aorta aortic valve disease Biological and medical sciences Biomarkers Biomarkers - blood Blood platelets Cardiology Cardiology. Vascular system cardiorenal syndrome Chi-Square Distribution Creatinine - blood cystatin C Cystatin C - blood eGFR Embolisms Emergency medical care emergency medicine endothelial function endothelium Female Glomerular Filtration Rate great vessels and trauma haematology Heart failure Humans Immunoassay Kaplan-Meier Estimate Kidney - physiopathology Kidney diseases Kidneys Lipocalin-2 Lipocalins - blood Male Medical prognosis Medical sciences Middle Aged mitral stenosis Mortality Multidetector Computed Tomography Multivariate Analysis N-GAL Nephrology. Urinary tract diseases Neutrophils Plasma Pneumology Poland Predictive Value of Tests Prognosis Proportional Hazards Models Prospective Studies Proto-Oncogene Proteins - blood pulmonary embolism Pulmonary Embolism - diagnosis Pulmonary Embolism - diagnostic imaging Pulmonary Embolism - mortality Pulmonary Embolism - physiopathology Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases quality of care and outcomes renal disease Renal failure renovascular disease Risk Assessment Risk Factors ROC Curve Sensitivity and Specificity Time Factors Urinary system involvement in other diseases. Miscellaneous Urine valvular disease venous thromboembolism Ventricular Function, Right |
| title | Neutrophil gelatinase-associated lipocalin, cystatin C and eGFR indicate acute kidney injury and predict prognosis of patients with acute pulmonary embolism |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-30T21%3A03%3A03IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Neutrophil%20gelatinase-associated%20lipocalin,%20cystatin%20C%20and%20eGFR%20indicate%20acute%20kidney%20injury%20and%20predict%20prognosis%20of%20patients%20with%20acute%20pulmonary%20embolism&rft.jtitle=Heart%20(British%20Cardiac%20Society)&rft.au=Kostrubiec,%20Maciej&rft.date=2012-08-01&rft.volume=98&rft.issue=16&rft.spage=1221&rft.epage=1228&rft.pages=1221-1228&rft.issn=1355-6037&rft.eissn=1468-201X&rft_id=info:doi/10.1136/heartjnl-2012-301884&rft_dat=%3Cproquest_cross%3E1027834457%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1780721916&rft_id=info:pmid/22705926&rfr_iscdi=true |