@article{3104823,
    title = "Short-term prognostic implications of serum and urine neutrophil gelatinase-associated lipocalin in acute heart failure: findings from the AKINESIS study",
    author = "Wettersten, N. and Horiuchi, Y. and van Veldhuisen, D.J. and Mueller, C. and Filippatos, G. and Nowak, R. and Hogan, C. and Kontos, M.C. and Cannon, C.M. and Müeller, G.A. and Birkhahn, R. and Taub, P. and Vilke, G.M. and Barnett, O. and McDonald, K. and Mahon, N. and Nuñez, J. and Briguori, C. and Passino, C. and Maisel, A. and Murray, P.T.",
    journal = "European Journal of Heart Failure",
    year = "2020",
    volume = "22",
    number = "2",
    pages = "251-263",
    publisher = "John Wiley and Sons Ltd",
    doi = "10.1002/ejhf.1642",
    keywords = "creatinine;  neutrophil gelatinase associated lipocalin;  biological marker;  neutrophil gelatinase associated lipocalin, acute heart failure;  aged;  Article;  cohort analysis;  creatinine blood level;  female;  hospital admission;  hospital readmission;  human;  human cell;  major clinical study;  male;  mortality rate;  outpatient department;  pathophysiology;  prediction;  priority journal;  prognosis;  prospective study;  protein blood level;  protein urine level;  renal replacement therapy;  acute kidney failure;  blood;  clinical trial;  heart failure;  multicenter study;  prognosis;  urine, Acute Kidney Injury;  Aged;  Biomarkers;  Female;  Heart Failure;  Humans;  Lipocalin-2;  Male;  Prognosis;  Prospective Studies",
    abstract = "Aims: Kidney impairment has been associated with worse outcomes in acute heart failure (AHF), although recent studies challenge this association. Neutrophil gelatinase-associated lipocalin (NGAL) is a novel biomarker of kidney tubular injury. Its prognostic role in AHF has not been evaluated in large cohorts. The present study aimed to determine if serum NGAL (sNGAL) or urine NGAL (uNGAL) is superior to creatinine for predicting short-term outcomes in AHF. Methods and results: The study was conducted in an international, multicentre, prospective cohort consisting of 927 patients with AHF. Admission and peak values of sNGAL, uNGAL and uNGAL/urine creatinine (uCr) ratio were compared to admission and peak serum creatinine (sCr). The composite endpoints were death, initiation of renal replacement therapy, heart failure (HF) readmission and any emergent HF-related outpatient visit within 30 and 60 days, respectively. The mean age of the cohort was 69 years and 62% were male. The median length of stay was 6 days. The composite endpoint occurred in 106 patients and 154 patients within 30 and 60 days, respectively. Serum NGAL was more predictive than uNGAL and the uNGAL/uCr ratio but was not superior to sCr [area under the curve: admission sNGAL 0.61, 95% confidence interval (CI) 0.55–0.67, and 0.59, 95% CI 0.54–0.65; peak sNGAL: 0.60, 95% CI 0.54–0.66, and 0.57, 95% CI 0.52–0.63; admission sCr: 0.60, 95% CI 0.54–0.64, and 0.59, 95% CI 0.53–0.64; peak sCr: 0.61, 95% CI 0.55–0.67, and 0.59, 95% CI 0.54–0.64, at 30 and 60 days, respectively]. NGAL was not predictive of the composite endpoint in multivariate analysis. Conclusions: Serum NGAL outperformed uNGAL but neither was superior to admission or peak sCr for predicting adverse events. © 2019 The Authors. European Journal of Heart Failure © 2019 European Society of Cardiology"
}