Neutrophil gelatinase-associated lipocalin as diagnostic and prognostic tool for cardiovascular disease and heart failure

INTRODUCTION: Cardiovascular disease (CVD) has been a burden on the healthcare system for decades and has increased the need for earlier diagnosis, better risk stratification and cost- effective treatment to reduce the rates of hospitalization. Biomarker research has broadened our knowledge base, shedding more light on the underlying pathophysiological mechanisms associated with the development of heart disorders. Recent technological advances have made it possible to use noninvasive and cost-effective biomarkers for identifying patients who are at risk of developing coronary heart disease and atherosclerosis. AREAS COVERED: In this paper the authors review the development of neutrophil gelatinase-associated lipocalin (NGAL) as a cardiac biomarker, highlighting studies that validate its use in predicting acute changes in patients with an array of cardiac disorders, and stake a case for the use of NGAL as a clinical diagnostic tool to predict outcomes in patients with CVD. EXPERT OPINION: The authors believe that NGAL should be used as a clinical diagnostic tool to predict outcomes in patients with CVD. Growing evidence has illustrated the biological role that neutrophils, such as NGAL, play in inflammation and atherosclerosis. Further studies are needed to determine NGAL's stability in serum and urine, and to substantiate its widespread use, but there are expanding possibilities for this biomarker in clinical practice.