Abstract 10990: Plasma Heart-type Fatty Acid Binding Protein Level is Associated With Outcomes in Out-of-hospital Cardiac Arrest Patients
Introduction: Biomarkers would be helpful for early prognosis in out-of-hospital cardiac arrest (OHCA) patients. Heart-type fatty acid binding protein (H-FABP) is a tissue-specific protein which is rapidly released into the circulation when the cardiomyocyte injuries happen. The role of circulating H-FABP level for outcomes remains unclear in OHCA patients.
Hypothesis: The higher plasma level of H-FABP is associated with worse outcome in OHCA patients.
Methods: The study was a prospectively cohort study enrolling non-traumatic resuscitated OHCA patients in a tertiary medical center. All of the cardiac arrest event variables were recorded according to the Utstein style recommendations. Blood samples were collected at 24 hours after cardiac arrest and resuscitation. The primary endpoint was defined as the survival to discharge. The secondary endpoint was neurological status at time point of hospital discharge evaluated by cerebral performance category (CPC) score and survival to 90 days.
Results: A total of 69 OHCA patients were enrolled for the study. There were 29 patients survived to hospital discharge and 11 patients with favorable neurological outcomes when discharge. Patients with the highest tertile of plasma H-FABP level at 24 hrs after event has longer CPR duration (p=0.026) and higher amount of epinephrine used during CPR (p=0.041). The outcomes of survival to discharge and neurological status were worse in the patient group with the highest tertile plasma H-FABP level at 24 hrs after event (p=0.011 and 0.013 respectively). Multivariate analysis demonstrated the tertiles of H-FABP at 24 hrs was predictive of in-hospital mortality: 1st tertile hazard ratio (HR) 1.0; 2nd tertile HR 2.177(95% confidence interval 0.790~5.999, p=0.133); 3rd tertile HR 5.288 (95% confidence interval 1.907~14.663, p=0.001). Compared to cardiac troponin I, the level of H-FABP at 24 hrs was a better predictor for the outcome of survival to discharge in OHCA patients in receiver-operating characteristic curves analysis (p=0.017).
Conclusions: Myocardial injuries occur in the post-cardiac arrest phase. Heart-type fatty acid binding protein in early post-cardiac arrest phase is associated with survival to discharge in OHCA patients.
- © 2012 by American Heart Association, Inc.