Abstract 16402: Feasibility of Combined Evaluation of Brain Natriuretic Peptide and Heart-Type Fatty Acid Binding Protein in Female Patients with Heart Failure
Background: Heart failure (HF) in women remains poorly recognized and poorly understood syndrome. The objective of this work is to investigate sex differences in etiology, diagnosis and prognostic testing. We examined whether combination of brain natriuretic peptide (BNP) and heart-type fatty acid binding protein (H-FABP) can more effectively risk-stratify HF patients in women.
Methods and Results: BNP and H-FABP concentrations were measured in 459 patients with HF (282 in men and 177 in women) at admission. Patients were prospectively followed during a median follow-up period of 681 days with end points of cardiac death or re-hospitalization. Female patients were significantly older than male patients (70.8 ± 12 vs. 66.8 ± 13 years old, P < 0.01). The etiology of HF and cardiac event rates were not significantly different between men and women. There were no significant differences in estimated glomerular filtration rate, BNP and H-FABP between men and women. Cut-off value of BNP for predicting cardiac events was higher in female patients than in male patients (418 vs. 234 pg/ml). However those of H-FABP were similar between men and women (5.0 vs. 5.1 ng/ml). Based on the cut-off values of BNP and H-FABP of each gender, we stratified HF patients into 4 groups (BNP/H-FABP: low/low; high/low; low/high; high/high). In Kaplan-Meier analysis, high BNP and high H-FABP group demonstrated the highest cardiac event rate in both genders (P<0.0001, respectively). Higher relative risk for cardiac events was recognized in female patients compared with male patients (Figure).
Conclusions: Sex difference in plasma BNP levels may need to be considered to determine cut-off value for cardiac events. Furthermore, combined measurement of BNP and H-FABP concentrations at admission may be a highly reliable evaluation for risk-stratifying female patients with HF.
- © 2010 by American Heart Association, Inc.