Abstract 14116: Prognostic Utility of Heart Type Fatty Acid Binding Protein After Acute Myocardial Infarction
Aims; Although diagnostic utility of heart type fatty acid binding protein (H-FABP) is well known for acute myocardial infarction (AMI), little is known about its prognostic value after AMI.
Methods; We compared H-FABP and NT-proBNP levels in 1,283 patients registered to the Osaka Acute Coronary Insufficiency Study (OACIS). Serum samples were obtained more than 5 days after AMI onset and within 14 days before or after survival discharge. We investigated association between H-FABP and/or NT-proBNP levels and incidence of mortality, nonfatal reinfarction, or hospitalization for heart failure (HF).
Results; During the average follow up of 1,442 days, 81 patients died, 44 had nonfatal reinfarctions and 51 had hospitalization for HF. H-FABP levels in the highest quartile (more than 5.21 ng/ml, N=321) were associated with a higher incidence of death (14% vs 3.6%, p<0.01) and hospitalization for HF (9.0% vs 2.3%, p<0.01), but not with nonfatal reinfarction (4.0% vs 3.2%, p=0.48). Multivariate Cox regression analysis revealed that a minimally elevated H-FABP level (more than 5.21 ng/ml) was a significant predictor of mortality (hazard ratio (HR) 2.16, p<0.01) and hospitalization for HF (HR 2.40, p=0.02). Similarly, NT-proBNP level was predictive for mortality (HR 2.14, p=0.01) and hospitalization for HF (HR 5.49, p<0.01). Subgroup analysis suggested that patients with elevated H-FABP but without elevated NT-proBNP levels tended to have nonfatal reinfarction during the follow-up period (unadjusted HR 2.04, p=0.07).
Conclusions; Minimally elevated H-FABP levels in the chronic stage of MI predicted long term mortality and hospitalization for HF. Furthermore, when combined with NT-proBNP level, H-FABP level may be predictive for recurrent MI.
- © 2011 by American Heart Association, Inc.