Abstract 66: Heart-Type Fatty Acid-Binding Protein (H-Fabp) Strongly Correlates with in Hospital Mortality of Pulmonary Artery Embolic Events
Accumulating evidence indicates that elevated serum troponin levels are a reliable indicator of myocardial injury in patients with acute pulmonary artery embolism (PE) that additionally correlates with in hospital mortality in such individuals. Recent investigations have demonstrated that heart-type fatty acid-binding protein (H-FABP) enables early and precise diagnosis and risk assessment of acute coronary syndrome as compared with other biomarkers. Currently there are no data whether this marker is useful in patients with PE. Therefore the aim of the present study was to determine whether H-FABP may be useful as a prognostic marker for these patients. Consecutive patients (n=39) with confirmed PE were included in the study. Besides serial measurements of cardiac troponin I (cTnI), D- dimer and creatine kinase (CK), a qualitative H-FABP-test (CardioDetect®med, rennesens, Berlin) was performed on arrival at the intensive care unit and 1 hour afterwards. The positive cut-off for this test was 7ng/ml. Echocardiography was performed in all patients with specific focus on the right ventricular parameters. Of the included 39 patients, 7 had positive H-FABP-tests. Echocardiographic right ventricular function was moderately to severely deteriorated with typical ventricular motion abnormality in all 7 patients of the positive group and in none of the negative group (p<0.005). 7/7 patients (100%) of the positive group needed inotropic support, 6 of these severely compromised patients (86%) died during the hospital stay in the course of the disease. No patient with a negative test (n= 32) needed vasoactive drugs, which finally translated into an in-hospital mortality as low as 0% (p<0.005). All patients of the positive group also had high cTnI-levels, but only 28% (n= 9) of the H-FABP negative group were cTnI positive. H-FABP had a significantly higher correlation with in-hospital mortality than troponin I (p<0.005). These data show that H-FABP was a strong predictor for impaired right ventricular function in patients with acute PE. It correlates significantly better with in-hospital mortality than Troponin I and may thus become an easily available, novel tool for optimizing the management strategy in patients with acute PE.