Predictive research on the adverse outcome of persistently high level of heart-type fatty acid-binding protein in chronic heart failure patients

doi:10.3969/j.issn.1673-8640.2014.09.015

Abstract

Abstract: Objective To study the variation regularity of heart-type fatty acid-binding protein (H-FABP) at different stages in patients with chronic heart failure (CHF), and to investigate the predictive significance of persistently high level of H-FABP for early adverse outcome. Methods Serum H-FABP and B-type natriuretic peptide (BNP) levels were determined among 184 CHF patients at both admission and discharge and 100 healthy controls (healthy control group). According to the determination results, they were classified into 2 groups, low H-FABP level group (82 cases, Group 1) and high H-FABP level group (102 cases, Group 2). Follow-up study was made for the 2 groups, respectively, and their adverse outcomes were observed. Results The H-FABP level of healthy control group was ≤0.6 ng/mL. The H-FABP levels of Group 1 were low at both admission and discharge[3.042±0.914, (2.891±0.890) ng/mL]. The H-FABP levels of Group 2 were high at both admission and discharge[12.276±3.991, (9.374±3.116) ng/mL]. During the follow-up period, 54 cases had cardiovascular events (29.35%, 54/184, 24 died cases and 30 readmitted cases). There were 10 cases(12.20%) in Group 1 and 44 cases(43.14%) in Group 2 with cardiovascular events with statistical significance between the 2 groups (P<0.01). Kaplan-Meier curve showed Group 2 had evidently worse event-free rate than Group 1 (P<0.001). H-FABP increased significantly before cardiovascular events with an average of 27 d, while BNP increased earlier than cardiovascular event occurrence with an average of10 d. That of H-FABP was 17 d earlier than that of BNP. Univariate Cox proportional hazard analysis demonstrated that age, New York Heart Academy (NYHA) classification,BNP and H-FABP were all related to cardiovascular events. Multivariate Cox proportional hazard analysis showed that the persistently high level of H-FABP was an independent factor for cardiovascular events (OR=5.462,P<0.000 1). Conclusions Monitoring the level of H-FABP is a new tool that provides clinical information to predict prognosis and guide the therapy efficacy for CHF patients.

Key words: Heart-type fatty acid-binding protein, Chronic heart failure, Prognosis

CLC Number:

R446.1

ZHONG Ling, HUANG Wenfang. Predictive research on the adverse outcome of persistently high level of heart-type fatty acid-binding protein in chronic heart failure patients[J]. , 2014, 29(9): 935-940.

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