Combination of heart-type fatty acid binding protein and brain natriuretic peptide can reliably risk stratify patients hospitalized for chronic heart failure.
BACKGROUND
The aim of the present study was to prospectively study whether a combination of markers for myocardial cell injury and left ventricular overload at admission can reliably risk stratify patients hospitalized for chronic heart failure (CHF).


RESULTS
Serum concentrations of heart-type fatty acid binding protein (H-FABP) and plasma concentrations of brain natriuretic peptide (BNP) were measured at admission in 186 consecutive patients hospitalized for CHF. During a mean follow-up period of 534+/-350 days, there were 44 cardiac events, including 16 cardiac deaths and 28 readmissions for worsening heart failure. Normal upper limits for H-FABP and BNP values were determined from the receiver operating characteristic curves (4.3 ng/ml for H-FABP and 200 pg/ml for BNP). A stepwise Cox regression analysis demonstrated that high H-FABP (hazard ratio 5.416, p = 0.0002) and high BNP (hazard ratio 2.411, p = 0.0463) were independent predictors of cardiac events. High concentrations of both H-FABP and BNP at admission were associated with the highest incidence of cardiac mortality and cardiac events. Kaplan-Meier analysis also showed that the combination of H-FABP and BNP concentrations could reliably stratify patients for cardiac events.


CONCLUSIONS
Combined measurement of H-FABP and BNP concentrations at admission may be a highly reliable evaluation for risk stratifying patients hospitalized for CHF.
Niizeki
Takeshi
T
First Department of Internal Medicine, Yamagata University School of Medicine, Yamagata, Japan.
Takeishi
Yasuchika
Y
Arimoto
Takanori
T
Takahashi
Tatsuya
T
Okuyama
Hidenobu
H
Takabatake
Noriaki
N
Nozaki
Naoki
N
Hirono
Osamu
O
Tsunoda
Yuichi
Y
Shishido
Tetsuro
T
Takahashi
Hiroki
H
Koyama
Yo
Y
Fukao
Akira
A
Kubota
Isao
I
D000368:Aged; D015415:Biomarkers / Q000097:blood; D002352:Carrier Proteins / Q000097:blood*; D050556:Fatty Acid-Binding Proteins; D005260:Female; D006333:Heart Failure / Q000097:blood*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D018579:Patient Selection; D011446:Prospective Studies; D012307:Risk Factors
D015415:Biomarkers; D002352:Carrier Proteins; D050556:Fatty Acid-Binding Proteins; D020097:Natriuretic Peptide, Brain