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The following is a summary of “Evaluation of neutrophil gelatinase-associated lipocalin (NGAL), hypoxia-induced factor-1 alpha (HIF-1α) and apelin 13 levels as new potential biomarkers for pulmonary thromboembolism: a prospective clinical study,” published in the August 2024 issue of Pulmonology by Baykal et al.

This study aimed to assess the diagnostic and prognostic value of serum levels of neutrophil gelatinase-associated lipocalin (NGAL), hypoxia-induced factor-1 alpha (HIF-1α), and apelin 13 in patients with acute pulmonary thromboembolism (PE), stratified by different mortality risk groups. Conducted at a tertiary referral center, the study included 124 subjects: 94 diagnosed with PE and 30 healthy controls, all aged 18 years or older. The diagnosis of PE was confirmed via computed tomography angiography of the thorax, and serum levels of NGAL, HIF-1α, and apelin 13 were measured using a commercial enzyme-linked immunosorbent assay (ELISA) kit.

The median age of the patient group was 68 years (IQR: 56-76), while the control group had a median age of 61.5 years (IQR: 56-67). Among the patients with PE, 97.88% had identifiable risk factors, with only 2.12% having no known risk factors. HIF-1α levels were significantly elevated in the patient with the PE group compared to controls (p = 0.03). Furthermore, HIF-1α levels were notably higher in the high mortality risk group than in the control group, low mortality risk group, and intermediate-low mortality risk group (p < 0.001, p = 0.011, p = 0.002, respectively). Although NGAL levels did not significantly differ between the patient and control groups, they were markedly higher in the high mortality risk group compared to the control group, low mortality risk group, and intermediate-low mortality risk group (p = 0.001, p < 0.001, p = 0.010, respectively). No significant differences in apelin 13 levels were observed across the groups.

In conclusion, HIF-1α emerges as a promising biomarker for distinguishing between patients with PE and healthy controls and for identifying those with a high mortality risk. Similarly, NGAL proves to be a valuable biomarker in identifying patients with PE with an elevated risk of mortality. However, apelin 13 is not a significant marker in this context. These findings suggest that HIF-1α and NGAL could enhance the clinical management of PE by aiding in risk stratification and prognosis.

Source: sciencedirect.com/science/article/abs/pii/S0954611124002518