https://doi.org/10.1007/s00392-025-02625-4
1Universitätsklinikum Regensburg Klinik und Poliklinik für Innere Med. II, Kardiologie Regensburg, Deutschland; 2Krankenhaus Barmherzige Brüder Regensburg Klinik für Kardiologie Regensburg, Deutschland
The goal of the current study was to evaluate the prognostic value of the potential cardiorenal biomarkers kidney injury molecule-1 (u-KIM-1) and N-acteyl-ß-D-glucosaminidase (NAG) regarding mortaliy and major adverse cardiac events in patients presenting with acute chest pain in the emergency department.
Methods and Results
The study cohort consisted of 296 patients who presented themselves with acute chest pain in the emergency department of the university hospital Regensburg. The urinary concentrations of NAG and u-KIM-1 were measured alongside Troponin I and NT-proBNP. The patients were followed for 60 months regarding the primary endpoints mortality of any cause and major adverse cardiac events, consisting of mortality, congestive heart failure, acute kidney injury and stroke (MACE). 54 patients died during the follow-up and 97 suffered from MACE. Regarding ROC-analysis NAG as well as u-KIM-1 showed promising predictive values (all-cause mortality: AUCNAG 0.821, AUCKIM-1 0.745, MACE: AUCNAG 0.778, AUCKIM-1 0.692).
According to Kaplan-Meier analysis, patients with > median concentrations of NAG and u-KIM-1 showed a significant worse outcome regarding MACE as well as all-cause mortality (each p< 0.001). Furthermore, Cox regression analysis revealed NAG as independent predictor beside NT-proBNP and older age for mortality due to any cause and MACE (each p< 0.001), opposite to u-KIM-1, hypertension and diabetes (each p=n.s.).
Conclusion
Urinary N-acteyl-ß-D-glucosaminidase and, to a lesser extent, kidney injury molecule-1 showed significant value in prediction mayor adverse cardiac events and mortality due to any cause in patients with acute chest pain.