Plasma ngal and tmao levels in relation to coronary thrombus burden among patients with st-elevation myocardial infarction: A cross-sectional study

Abstract Background and Aims ST-elevation myocardial infarction (STEMI) represents the most severe manifestation of acute coronary syndromes and is frequently associated with a high coronary thrombus burden, which adversely affects therapeutic success and clinical prognosis. Biomarkers such as neutrophil gelatinase-associated lipocalin (NGAL) and trimethylamine N-oxide (TMAO) have emerged as potential predictors of thrombus burden. This study aims to investigate the association between plasma NGAL and TMAO levels and coronary thrombus burden in patients with STEMI. Methods This cross-sectional study enrolled patients with STEMI undergoing coronary angiography. Plasma NGAL and TMAO levels were measured from venous blood samples, while coronary thrombus burden was assessed angiographically using the TIMI thrombus grading system. Results Among 63 patients with ST-elevation myocardial infarction, plasma TMAO levels were significantly higher in the high thrombus burden group than in the low thrombus burden group (93.0 ± 27.2 vs. 73.3 ± 32.5 ng/mL; p = 0.011) and independently predicted thrombus burden (OR 1.022; p = 0.025). In contrast, NGAL levels did not differ significantly between groups (median 93 vs. 98 ng/mL; p = 0.145), although a weak inverse correlation between NGAL and TMAO was observed (r = −0.280; p = 0.026). Conclusion In patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention, plasma TMAO levels were significantly associated with and independently predicted coronary thrombus burden, whereas NGAL showed no significant predictive value. TMAO may serve as a useful non-invasive biomarker for early thrombotic risk stratification in STEMI, while NGAL primarily reflects inflammatory processes rather than thrombus severity.Table 1a.Pulmonary Function Parameters Before and After Intervention in Patients with Acyanotic CHD with Left-to-Right Shunt, 1b. Pulmonary Function Parameters Before and After Intervention Based on Intervention Category