Abstract 10066: A Comparison of B-type Natriuretic Peptide and Heart-type Fatty Acid Binding Protein as Predictors of Cardiac Events in Heart Failure Patients with Chronic Kidney Disease
Background: Heart-type fatty acid binding Protein (H-FABP) reveals the presence of ongoing myocardial damage. B-type natriuretic peptide (BNP) is the most established marker of neurohormonal factors. Both biomarkers are predictors of subsequent cardiac events in patients with chronic heart failure (CHF). Clinical predictors of both biomarkers in the presence of chronic kidney disease (CKD) are clearly unknown. We investigated whether H-FABP and BNP were useful in CHF patients with and without CKD.
Methods and Results: We measured BNP and H-FABP in 194 patients hospitalized for CHF. Patients with estimated glomerular filtration rate <60 ml/min/1.73 m2 were considered to have CKD, and 99 (51%) had CKD. During a mean 781 ± 616 days, there were 74 cardiac events (cardiac death and readmissions for worsening CHF). We investigated prospectively using cut-off value in our previous studies (4.3ng/ml for H-FABP and 200pg/ml for BNP). Kaplan-Meier analysis demonstrated that curves of cardiac event-free rate of the 2 groups on the basis of cut-off values were all significantly different between with and without CKD (H-FABP without CKD, p=0.0055; H-FABP with CKD, p<0.0001; BNP without CKD, p=0.0021; BNP with CKD, p=0.0325, respectively) Multivariate Cox proportional analysis demonstrated that high H-FABP (hazard ratio [HR] 2.636, p=0.0330) and high BNP (HR 4.658, p=0.0036) were independent predictors of cardiac events in patients with CHF without CKD. However, in CHF patients with CKD, high H-FABP but not BNP was an independent predictor of cardiac events (HR 7.887, p=0.0051 and HR 1.106, p=0.8196, respectively).
Conclusions: H-FABP independently predicted cardiac death and events in CHF patients with and without CKD. Additionally, in patients with CHF with CKD, H-FABP had may be a superior marker for cardiac events to BNP.
- © 2010 by American Heart Association, Inc.