Predictive value of Neutrophil-Gelatinase-Associated Lipocalin on the Severity of coronary artery diseases and development of Contrast-Induced Nephropathy after Percutaneous Coronary Interventions

Background: Contrast-induced acute kidney injury (CI-AKI) is a common complication among patients undergoing percutaneous coronary intervention (PCI). Neutrophil gelatinase associated lipocalin (NGAL) is a glycoprotein stored in granules of mature neutrophils released by renal tubular cells following acute tubular damage. Objective: This study aimed to assess the role of neutrophil gelatinase associated lipocalin (NGAL) as a novel noninvasive biomarker in prediction of contrast-induced nephropathy (CIN) and the severity of coronary artery disease (CAD). Patients and Methods: This study was conducted as an observational Cross-sectional study included 50 patients who were admitted to the catheterization laboratory at Zagazig University Cardiovascular Department for PCI from the period of 2014-2020. Patients were divided into two groups: Group A (nephropathy group) included patients who developed impairment of kidney function and group B (non-nephropathy) group. All patients were subjected to demographic data taking, full general (BP, Pulse, etc.) and local examination. ECG analysis, laboratory investigation, echocardiographic examination (According to ASE 2015) and coronary angiography. Results: The difference between the two groups regarding post-PCI serum creatinine, pre-PCI NGAL and post-PCI NGAL was statistically significant. ROC curve was constructed for estimating the validity of post-PCI NGAL as a predictor for contrast-induced nephropathy and it was found that at cut-off value of 131 μg/l was 92% for sensitivity and 76% for specificity with AUC of 0.92 by ROC analysis Conclusions: We concluded that among ischemic heart disease patients who underwent PCI, baseline NGAL levels identified patients at high risk for the development of CI-AKI. Also we found that pre-coronary angio NGAL can predict the severity of CAD.