Abstract 17429: The Efficacy of Serum Heart-Type Fatty Acid-Binding Protein (HFABP) Level for Patients Who Admitted to Cardiovascular Intensive Unit
Background: The biomarkers to detect acute kidney injury (AKI) and predict adverse outcomes were unknown for cardiovascular intensive care patients.
Methods: Seven-hundred twelve patients admitted to the cardiovascular intensive care unit were prospectively analyzed. The serum the heart-type fatty acid-binding protein (s-HFABP), high sensitivity troponin-T (s-HsTnT), and N-Terminal pro-brain-type natriuretic peptide (s-NTproBNP) were measured within 30 minutes of admission. Patients were assigned to a no-AKI (n=560) or AKI group (n=151). AKI patients were also divided based on the degree of AKI using the RIFLE classifications on admission: Class R (n=90), Class I (n=44) or Class F (n=17), and based on the timing of AKI during first 5 days: stable RIFLE class during first 5 days (stable AKI; n=98), or step-up RIFLE class during first 5 days (worsening AKI; n=53). We evaluated the relationships between the biomarkers and AKI, the degree of AKI, timing of AKI, in-hospital mortality, all-cause death within one year.
Results: S-HFABP, HsTnT and NTproBNP were significantly higher in the AKI group than in the no- AKI group, and the s-HFABP and NTproBNP were significantly higher in the ClassI/F and worsening AKI group than in the other groups, respectively. The specific biomarker for AKI, Class I/F and worsening AKI was s-HFABP (OR: 1.928; 95% CI: 1.282-2.898, OR: 2.987; 95% CI: 1.607-5.549, and OR: 3.174; 95% CI: 1.657-6.080) by the multivariate analysis. Furthermore, the specific biomarker for in-hospital mortality was also s-HFABP (OR: 2.578; 95% CI: 1.491-4.458). S-HFABP demonstrated an optimal balance between sensitivity and specificity (69.1% and 60.3%; AUC=0.678) at 15.2 ng/ml for AKI, at 32.1 ng/ml for Class I /F (63.8% and 74.2%; AUC=0.722), at 29.8 ng/ml for worsening AKI (66.7% and 72.7%; AUC=0.728), and at 21.0 ng/ml for in-hospital mortality (81.8% and 63.2%; AUC=0.763). The Kaplan-Meier survival curves showed that the all-cause death was significantly more in the high serum HFABP group (≥ 21.0 ng/ml) than in the low serum HFABP group (< 21.0 ng/ml).
Conclusions: The serum HFABP level can indicate AKI, especially severe and worsening AKI, and a high serum HFABP level is associated with poorer prognosis in cardiovascular intensive care patients.
- © 2013 by American Heart Association, Inc.