Serum TIMP-2, NGAL and angiopoietin-2 as biomarkers of coronary artery stenosis

Background and Aim: Coronary artery atherosclerosis develops through the interplay of lipid metabolism, vascular endothelial activation and immune cell activation. In this study, newly discovered biomarkers for vascular inflammation and activation were tested for diagnostic strength in angiographically significant coronary artery stenosis. Methods: Serum levels of NGAL, TIMP2, IL-8, GRO alpha, angiopoietin-2, bFGF and hsCRP were measured in 70 patients undergoing coronary angiography. Severity of disease was evaluated from angiographic findings based on the modified Gensini score. Results: Serum TIMP-2, NGAL and angiopoietin-2 levels were significantly elevated in patients with coronary artery stenosis (P = 0.002, P = 0.01 and P = 0.01, respectively) and correlated significantly with the number of stenotic coronary arteries. Receiver operating characteristic analysis of TIMP-2, NGAL and angiopoietin-2 showed significantly increased areas under the curve (AUC = 0.795, 0.728, and 0.722, respectively). Multivariate analysis revealed that the elevated serum angiopoietin-2, old age and current smoking significantly and independently predicted the presence of coronary artery stenosis (P = 0.022, P = 0.006 and P = 0.004, respectively). Conclusion: Serum TIMP-2, NGAL and angiopoietin-2 levels may be useful in predicting the presence and severity of coronary artery stenosis.