Abstract 2913: Persistently Increased Serum Concentrations Of Heart-type Fatty Acid-binding Protein Predict Adverse Outcomes In Patients With Chronic Heart Failure
Background: H-FABP is a small cytosolic protein and released into the circulation when the myocardium is injured. We previously demonstrated that H-FABP level at admission was a novel marker for myocardial cell injury and prognosis in CHF patients. In this study we examined whether serial measurements of H-FABP levels provide additional prognostic information.
Methods: We measured serum H-FABP levels at both admission and discharge in 112 CHF patients, and patients were followed up (mean 686 days) to register cardiac events. Cut off value for H-FABP was determined from ROC curve in previous studies.
Results: The median H-FABP level was 7.4 ng/ml at admission and 4.9 ng/ml at discharge. The following 3 patterns of changes in H-FABP levels were identified. In 41 patients, H-FABP levels (< 4.3 ng/ml) at both admission and discharge were normal (Group 1). The remaining 71 patients had high initial H-FABP levels (≥ 4.3 ng/ml) at admission. In 20 of these 71 patients (28%), H-FABP decreased to normal range at discharge (Group 2), whereas 51 had persistently high H-FABP levels despite improvement in symptoms and signs of CHF (Group 3). There were 32 cardiac events (29%) during a follow-up period. Kaplan-Meier analysis demonstrated that Group 3 had significantly higher cardiac event rates than Groups 1 and 2 (Figure A⇓). A stepwise Cox regression analysis also demonstrated that Group 3 was associated with the highest cardiac event risk among 3 groups (hazard ratio 5.68, P = 0.012) (Figure B⇓).
Conclusion: These results suggest that serial measurements of H-FABP levels are a new monitoring tool, which provides helpful information to guide optimal therapy and manage CHF patients.