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The relationship between neutrophil gelatinase-associated lipocalin levels and the slow coronary flow phenomenon

Aksan, Gokhana; Soylu, Korhanc; Aksoy, Olcayf; Özdemir, Metinb; Yanik, Ahmetd; Yuksel, Serkanc; Gedikli, Ömere; Gulel, Okanc; Şahin, Mahmutc

doi: 10.1097/MCA.0000000000000121
Original Research

Objectives: There is accumulating evidence that inflammation plays a major role in the development of the slow coronary flow (SCF) phenomenon. In this study, we aimed to study the biomarker neutrophil gelatinase-associated lipocalin (NGAL) as it relates to SCF.

Materials and methods: Patients who underwent coronary angiography before and had no significant epicardial coronary disease were included in the study. Patients who had Thrombolysis in Myocardial Infarction frame counts (TFCs) above the normal cutoffs were considered to have SCF and those within normal limits were considered to have normal coronary flow (NCF). The NGAL levels and biochemical profiles of all patients were studied and analyzed with coronary flow parameters.

Results: There were 50 patients in the SCF group and 50 patients in the NCF group. The serum NGAL level was higher in those patients in the SCF group versus the NCF group (75.2±39.7 vs. 50.6±24.2, P<0.001). There was a significant correlation between the NGAL levels and TFC (r=0.684, P<0.001). Multivariable regression analysis showed that the NGAL levels were an independent predictor of the SCF phenomenon (odds ratio=1.060, 95% confidence interval: 1.008–1.115, P=0.023).

Conclusion: In this study, we show that patients with SCF have elevated levels of NGAL. We further show a strong correlation between the NGAL levels and coronary blood flow. We conclude that elevated NGAL levels might be a useful tool in predicting SCF in patients who undergo coronary angiography.

Departments of aCardiology

bMicrobiology, Gazi State Hospital

cDepartment of Cardiology, Faculty of Medicine, Ondokuz Mayis University

dDepartment of Cardiology, Samsun Training and Research Hospital, Samsun

eDepartmant of Cardiology, Artvin State Hospital, Artvin, Turkey

fDepartment of Cardiology, University of California, Los Angeles, Los Angeles, California, USA

Correspondence to Korhan Soylu, MD, Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, 55139 Samsun, Turkey Tel: +90 362 3121919 x3249; fax: +90 362 4577146; e-mail:

Received December 23, 2013

Received in revised form March 12, 2014

Accepted March 17, 2014

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins