RT Journal Article SR Electronic T1 Neutrophil gelatinase-associated lipocalin prior to cardiac surgery predicts acute kidney injury and mortality JF Heart JO Heart FD BMJ Publishing Group Ltd and British Cardiovascular Society SP heartjnl-2017-311760 DO 10.1136/heartjnl-2017-311760 A1 Heerajnarain Bulluck A1 Raju Maiti A1 Bibhas Chakraborty A1 Luciano Candilio A1 Tim Clayton A1 Richard Evans A1 David P Jenkins A1 Shyam Kolvekar A1 Gudrun Kunst A1 Christopher Laing A1 Jennifer Nicholas A1 John Pepper A1 Derek M Yellon A1 Derek J Hausenloy YR 2017 UL http://heart.bmj.com/content/early/2017/08/09/heartjnl-2017-311760.abstract AB Objective We aimed to investigate whether preoperative serum neutrophil gelatinase-associated lipocalin (sNGALpre-op) predicted postoperative acute kidney injury (AKI) during hospitalisation and 1-year cardiovascular and all-cause mortality following adult cardiac surgery.Methods This study was a post hoc analysis of the Effect of Remote Ischemic Preconditioning on Clinical Outcomes in Patient Undergoing Coronary Artery Bypass Graft Surgery trial involving adult patients undergoing coronary artery bypass graft. Postoperative AKI within 72 hours was defined using the International Kidney Disease: Improving Global Outcomes classification.Results 1371 out of 1612 patients had data on sNGALpre-op. The overall 1-year cardiovascular and all-cause mortality was 5.2% (71/1371) and 7.7% (105/1371), respectively. There was an observed increase in the incidence of AKI from the first to the third tertile of sNGALpre-op (30.5%, 41.5% and 45.9%, respectively, p<0.001). There was also an increase in both cardiovascular and all-cause mortality from the first to the third tertile of sNGALpre-op, linear trend test with adjusted p=0.018 and p=0.013, respectively. The adjusted HRs for those in the second and third tertiles of sNGALpre-op compared with the first tertile were 1.60 (95% CI 0.78 to 3.25) and 2.22 (95% CI 1.13 to 4.35) for cardiovascular mortality, and 1.25 (95% CI 0.71 to 2.22) and 1.91 (95% CI 1.13 to 3.25) for all-cause mortality at 1 year.Conclusion In a cohort of high-risk adult patients undergoing cardiac surgery, there was an increase in postoperative AKI and 1-year mortality from the first to the third tertile of preoperative serum NGAL. Those in the last tertile (>220 ng/L) had an estimated twofold increase risk of cardiovascular and all-cause mortality at 1 year.Clinical trial registration NCT101247545; Post-results.