Neutrophil gelatinase-associated lipocalin (NGAL)
LCN2proteinNGAL is released by activated neutrophils and indicates acute kidney injury and renal dysfunction occurring as a hemodynamic consequence of MI.
Pathway placement
Cascade stepOff-pathway / systemic markers
Confidencemedium
RationaleAcute kidney injury marker post-MI; reflects renal stress and systemic hemodynamic consequence, not atherothrombotic cascade mechanistic marker.
Also acts inMyocardial injury
Druggability
DruggableYes
Known drugs / candidates0
Small-molecule tractableYes
Antibody tractableYes
EnsemblENSG00000148346
Type I vs Type II discrimination
ScoresShared / rises in both
R — rupture / Type-I100
C — confounder / Type-II56
A — assay feasibility68
E — evidence strength73
T1DI (composite)36
Specificity differential (R−C)+44
Confounder panel (Type-II drivers)
1sepsis / systemic inflammationmag 3
2anemia / acute blood lossn/a
3hypovolemia / dehydrationmag 2
4tachyarrhythmiamag 1
5hypoxemia / respiratory failuremag 1
6hypertensive emergencymag 1
7high-demand / peri-operative stressmag 2
Coverage: 6/7 confounders with evidence
Tier: deep-scored (abstract-extracted) · 20 supporting references. See the discrimination table for all markers.
Assay & specimen
Validated clinical assay
Specimen
Plasma or urine
Collection tube
K2/K3-EDTA (lavender-top) · Sterile urine container
Method / principle
Immunoassay / POC
Reagent / substrate
Anti-NGAL antibody pair
Platform
Automated / POC (Abbott)
Turnaround · availability
Rapid · CE/research
Human genetic evidence
0.026
Open Targets association (STEMI)
Literature evidence(8)
- Indexed neutrophil gelatinase associated lipocalin: a novel biomarker for the assessment of acute kidney injury.Journal of nephrology · 2023 · PMID 37917333 · doi
- Restricted T-Cell Repertoire in the Epicardial Adipose Tissue of Non-ST Segment Elevation Myocardial Infarction Patients.Frontiers in immunology · 2022 · PMID 35880176 · doi
- Novel biomarkers in the prognosis of patients with atherosclerotic coronary artery disease.Revista portuguesa de cardiologia · 2020 · PMID 33239161 · doi
- C-terminal fragment of agrin (CAF) levels predict acute kidney injury after acute myocardial infarction.BMC nephrology · 2017 · PMID 28646861 · doi
- Plasma cystatin C and neutrophil gelatinase-associated lipocalin in relation to coronary atherosclerosis on intravascular ultrasound and cardiovascular outcome: Impact of kidney function (ATHEROREMO-IVUS study).Atherosclerosis · 2016 · PMID 27680774 · doi
- Prognostic impact of established and novel renal function biomarkers in myocardial infarction with cardiogenic shock: A biomarker substudy of the IABP-SHOCK II-trial.International journal of cardiology · 2015 · PMID 25965624 · doi
- Role of inflammation in the pathogenesis of cardiorenal syndrome in a rat myocardial infarction model.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2013 · PMID 24009291 · doi
- From kidney to cardiovascular diseases: NGAL as a biomarker beyond the confines of nephrology.European journal of clinical investigation · 2010 · PMID 20415702 · doi