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Heart-type fatty acid binding protein is a novel prognostic marker in patients with non-ischaemic dilated cardiomyopathy
  1. K Komamura1,
  2. T Sasaki3,
  3. A Hanatani2,
  4. J Kim2,
  5. K Hashimura2,
  6. Y Ishida2,
  7. Y Ohkaru4,
  8. K Asayama4,
  9. T Tanaka5,
  10. A Ogai6,
  11. T Nakatani7,
  12. S Kitamura7,
  13. K Kangawa8,
  14. K Miyatake2,
  15. M Kitakaze2
  1. 1Department of Cardiovascular Dynamics, National Cardiovascular Centre Research Institute, Suita, Japan
  2. 2Division of Cardiology, National Cardiovascular Centre, Suita, Japan
  3. 3Division of Cardiology, Osaka Koseinenkin Hospital, Osaka, Japan
  4. 4Division of Laboratory Products, Dainippon Sumitomo Pharma Co, Ltd, Osaka, Japan
  5. 5Department of Pharmaceutical Life Sciences, Osaka University of Pharmaceutical Sciences, Takatsuki, Japan
  6. 6Department of Epidemiology, National Cardiovascular Centre Research Institute, Suita, Japan
  7. 7Department of Cardiovascular Surgery, National Cardiovascular Centre, Suita, Japan
  8. 8Department of Biochemistry, National Cardiovascular Centre Research Institute, Suita, Japan
  1. Correspondence to:
    Dr Kazuo Komamura
    National Cardiovascular Centre Research Institute, 5-7-1 Fujishirodai, Suita 565-8565, Japan; kkoma{at}hsp.ncvc.go.jp

Abstract

Objective: To determine whether concentrations of heart-type fatty acid binding protein (H-FABP) measured before hospital discharge predict critical cardiac events in patients with idiopathic dilated cardiomyopathy (DCM).

Patients: 92 consecutive patients with DCM were enrolled and followed up for four years.

Main outcome measures: Serum concentrations of H-FABP, brain natriuretic peptide (BNP), cardiac troponin T before hospital discharge and survival rate.

Results: 23 patients died of cardiac causes, received a left ventricular assist device or underwent heart transplantation during the four-year follow up. Univariate analyses showed that New York Heart Association functional class, heart rate, ejection fraction, serum H-FABP and plasma BNP were significant variables. According to multivariate analysis, serum H-FABP and plasma BNP concentrations were independent predictors of critical cardiac events. Cardiac troponin T before hospital discharge was not a predictor. The area under the receiver operating characteristic curve for death from critical cardiac events was similar between H-FABP and BNP. Patients with an H-FABP concentration at or above the median (⩾ 5.4 ng/ml) had a significantly lower survival rate than those below the median, according to analysis by log rank test (p < 0.0001). When combined with BNP concentration at or above the median (⩾ 138 pg/ml), H-FABP below the median predicted the worst prognosis among the combinations.

Conclusions: The concentration of serum H-FABP before discharge from hospital may be an independent predictor for critical cardiac events in DCM.

  • BNP, brain natriuretic peptide
  • cTnT, cardiac troponin T
  • DCM, dilated cardiomyopathy
  • H-FABP, heart-type fatty acid binding protein
  • brain natriuretic peptide
  • cardiac events
  • cardiomyopathy
  • fatty acid binding protein

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Footnotes

  • Published Online First 30 December 2005

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