Abstract 15438: A Massive Increase in Serum Levels of Fatty Acid Binding Protein 4 in Patients With Acute Myocardial Infarction Complicated by Out-of-Hospital Cardiac Arrest Due to Ventricular Fibrillation
Introduction: Circulating fatty acid binding protein 4 (FABP4) is associated with obesity, insulin resistance and cardiovascular events. We recently showed that FABP4 is activity secreted from adipocytes by β3-adrenergic stimulation and circulating FABP4 levels are robustly elevated in patients with acute myocardial infarction (AMI). Here we studied dynamic change of serum FABP4 levels in patients with AMI complicated and uncomplicated by out-of-hospital cardiac arrest (OHCA), which is due to ventricular fibrillation.
Methods and Results: One hundred six patients with AMI with and without OHCA were enrolled (12 OHCA, 94 non-OHCA). Serial blood samplings were performed; at admission, after percutaneous intervention (PCI), day 1 and day 3 after admission. At admission, demographic characteristics showed significant differences in heart rate (100 ± 13 vs. 79 ± 23 bpm, p=0.005) and glucose (280 ± 73 vs. 191 ± 83 mg/dl, p<0.001), suggesting that sympathetic nervous system is more activated in OHCA patients. Notably, FABP4 levels peaked at admission in both groups, but the median values (interquartile range) in OHCA patients were significantly higher than those in non-OHCA patients (figure below, p<0.001). FABP4 levels then declined over time in both groups, and the differences in FABP4 were significantly diminished on day 1 and 3. On the other hand, cardiac troponin T (cTnT) levels were comparable between the two groups at any time points although they peaked on day1 after admission, suggesting that a marked increase in FAPB4 in OHCA patients is independent of cardiac necrosis.
Conclusions: Our data demonstrate that AMI patients resuscitated from OHCA had a massive increase in FABP4 levels compared to those without OHCA. Given that ventricular tachyarrhythmia is accompanied by sympathetic overdrive, these data may support our hypothesis that serum FABP4 serves as a biomarker for sympathetic activity, representing catecholamine-induced adipocyte lipolysis.
Author Disclosures: H. Sunaga: None. T. Iso: None. M. Obokata: None. Y. Ohyama: None. N. Koitabashi: None. R. Funada: None. N. Takama: None. H. Matsui: None. T. Yokoyama: None. M. Murakami: None. M. Kurabayashi: None.
- © 2016 by American Heart Association, Inc.