title: Combination of heart-type fatty acid binding protein and brain natriuretic peptide can reliably risk stratify patients hospitalized for chronic heart failure.
abstract: 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.
authors.affiliation: First Department of Internal Medicine, Yamagata University School of Medicine, Yamagata, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Niizeki
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Takeishi
authors.forename: Takanori
authors.initials: T
authors.lastname: Arimoto
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Takahashi
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Okuyama
authors.forename: Noriaki
authors.initials: N
authors.lastname: Takabatake
authors.forename: Naoki
authors.initials: N
authors.lastname: Nozaki
authors.forename: Osamu
authors.initials: O
authors.lastname: Hirono
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Tsunoda
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Shishido
authors.forename: Hiroki
authors.initials: H
authors.lastname: Takahashi
authors.forename: Yo
authors.initials: Y
authors.lastname: Koyama
authors.forename: Akira
authors.initials: A
authors.lastname: Fukao
authors.forename: Isao
authors.initials: I
authors.lastname: Kubota
mesh_terms: 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
chemical_list: D015415:Biomarkers; D002352:Carrier Proteins; D050556:Fatty Acid-Binding Proteins; D020097:Natriuretic Peptide, Brain