Abstract 5858: Elevated Levels of Heart-Type Fatty Acid-Binding Protein Predict Adverse Outcomes in Hypertensive Patients
Background: Heart-type fatty acid-binding protein (H-FABP), a sensitive marker of myocardial damage, is useful for the diagnosis and evaluation of prognosis in patients with cardiovascular disease, not only acute coronary syndrome but also chronic heart failure. We hypothesized that H-FABP is a useful prognostic marker in patients with hypertension (HT), a risk factor of acute coronary syndrome and heart failure.
Methods: Serum levels of H-FABP were measured in 176 patients with essential HT without prior cerebro-cardiovascular disease (CCVD) and renal failure (estimated glomerular filtration rate [eGFR] < 30ml/min/1.73m2) and 38 controls.
Results: H-FABP is significantly higher in patients with essential HT than in the controls (4.8±5.7 versus 2.9±0.8 ng/ml, p=0.0001). Over a mean follow-up period of 55 months, 34 patients developed CCVD (15 heart failure, 3 acute coronary syndrome, 3 aortic dissection, 11 cerebral infarction, 1 cerebral hemorrhage and 1 transient ischemic attack). Kaplan-Meier analysis revealed that the freedom from CCVD rate was significantly lower in patients with H-FABP > 3.6 ng/ml (median value) than in those with H-FABP ≤ 3.6ng/ml (figure⇓). On a stepwise Cox multivariate analysis including 7 variables (age, BNP, H-FABP and cardiothoracic ratio > median value, eGFR < 60ml/min/1.73m2, smoking and LVH) that were significant predictors of CCVD by univariate analyses, H-FABP >3.6 ng/ml (hazard ratio 2.71, p=0.01) and smoking (hazard ratio 2.21, p=0.03) were independent predictors of future CCVD.
Conclusion: H-FABP is a novel and useful prognostic marker in patients with essential HT.