Abstract 18845: Clinical Significance of the Measurement of Urinary Liver-Fatty Acid-Binding Protein (LFABP) Excretion in Acute Heart Failure Patients
Background: The urinary neutrophil gelatinase-associated lipocalin (u-NGAL) had been reported as a golden standard urinary biomarker to detect the acute kidney injury (AKI). However, the clinical significance of urinary liver-fatty acid-binding protein (u-LFABP) in acute heart failure (AHF) patients was obscured yet.
Methods and Results: Two hundred ninety-four AHF patients who admitted to the intensive care unit and measured u-LFABP on admission were analyzed. The u-NGAL level was also evaluated from all patients as golden standard marker of AKI. The median u-LFABP levels were 57.5 [14.5 to 183.5] ng/ml•cre, and u-LFABP were significantly correlated with u-NGAL level on admission (r=0.447, p<0.001). The patients were divided to two group according to the quartiles of u-LFABP (Q1 (Low-LFABP group) v.s. Q2, Q3 and Q4 (High-LFABP group)). We evaluate the diagnostic and prognostic value of u-LFABP in each chronic kidney disease (CKD) (n=166) or non-CKD patients (n=129). AKI on admission was evaluated based on the RIFLE classification, which was the ratio of the serum creatinine value recorded on admission to the baseline creatinine value. In CKD patients, the number of AKI patients was not different between Low-LFABP and High-LFABP group. Kaplan-Meier curves showed that the survival rate of the Low-group was not significantly different in comparison with that of High-LFABP group. Meanwhile, in non-CKD group, the number of AKI patients was significantly more in High-LFABP group (38.0 % v.s. 19.4%). A multivariate logistic regression model indicated that High-LFABP group (OR 2.633, 95%CI 1.041-6.064, p=0.042) was independently associated with AKI on admission. The sensitivity and specificity of u-LFABP for detecting AKI were 69.0% and 57.0% (AUC 0.638) at 42.6 ng/ml•cre. Cox regression model identified that high-LFABP group (HR: 0.667, 95%CI 0.447 to 0.996) was an independent predictor of 180-day mortality. A Kaplan-Meier curve, including all-cause death within 90 days, showed a significantly poor survival rate in High-LFABP than in Low-LFABP group (p=0.029).
Conclusions: The u-LFABP level is an effective biomarker for detecting AKI on admission and predicting adverse outcome in AHF patients complicated with CKD.
Author Disclosures: A. Shirakabe: None. N. Hata: None. N. Kobayashi: None. H. Okazaki: None. M. Matsushita: None. J. Shibuya: None. S. Nishigoori: None. K. Asai: None. W. Shimizu: None.
- © 2016 by American Heart Association, Inc.