The aim of this study is to investigate the association between NGAL plasma levels in ST-elevation myocardial infarction and the no-reflow phenomenon, adverse events during hospitalization and at 30-day follow-up.
Neutrophil Gelatinase-associated Lipocalin (NGAL) is a acute phase protein which is elevated in conditions like acute kidney injury and myocardial infarction. When a coronary artery is occluded, detrimental changes occur in myocardial vessels. After relief of the occlusion, blood flow to the heart may still be impeded, a phenomenon known as "no-reflow". Data is lacking on factors associated with early detection of patients at risk for this phenomenon, and early stratification of this group seems vital since the no-reflow phenomenon is associated with worse outcomes. The investigators hypothesized that there might be an association between higher NGAL levels and the occurrence of no-flow findings, and that NGAL might serve as a marker of worse prognosis in this population. The investigators also hypothesized that NGAL levels might serve as a marker of early acute kidney injury and that there might be specific patterns of NGAL levels over time in different subsets of patients. The aim of the study is to determine the association between NGAL levels at admission and during the first days after a ST-elevation myocardial infarction, the occurrence of the no-reflow phenomenon, the extent of myocardial damage ascertained by cardiac imaging techniques (echocardiography and cardiac resonance imaging). Data regarding patients' clinical, laboratory, electrocardiogram, coronary angiography and percutaneous coronary intervention, in-hospital and 30-day follow-up after discharge will be recorded.
Study Type
OBSERVATIONAL
Enrollment
100
NGAL levels early and post ST elevation MI (STEMI)
Sheba Medical Center, Cardiac Intensive Care Unit
Ramat Gan, Israel
No-reflow phenomenon after STEMI
No-reflow phenomenon as defined by electrocardiographic, angiographic and cardiac magnetic resonance imaging criteria.
Time frame: During hospitalization
In-hospital MACE(major adverse cardiac events)
In-hospital MACE
Time frame: Average day 5 of hospitalization and before discharge
30-day MACE
30-day MACE
Time frame: 30-day follow-up
Serial creatinine level
Creatinine levels as a maker of acute kidney injury reported in mg/dl
Time frame: On admission and at fixed time intervals (first 3 hours after admission, 12 hours, 24 hours and every 24 hours or before if indicated)
The need for renal replacement therapy after STEMI
Patients started on hemodyalisis due to acute kidney injury during the index hospitalization
Time frame: In-hospital (usually 5 days)
Recurrent hospitalization
Recurrent hospitalization at 30 days after the index hospitalization
Time frame: 30 days
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