Heart-type fatty acid binding protein is a novel prognostic marker in patients with non-ischaemic dilated cardiomyopathy.
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).


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


METHODS
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 (> or = 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 (> or = 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.
Komamura
K
K
Department of Cardiovascular Dynamics, National Cardiovascular Centre Research Institute, Suita, Japan. kkoma@hsp.ncvc.go.jp
Sasaki
T
T
Hanatani
A
A
Kim
J
J
Hashimura
K
K
Ishida
Y
Y
Ohkaru
Y
Y
Asayama
K
K
Tanaka
T
T
Ogai
A
A
Nakatani
T
T
Kitamura
S
S
Kangawa
K
K
Miyatake
K
K
Kitakaze
M
M
D015415:Biomarkers / Q000097:blood; D002311:Cardiomyopathy, Dilated / Q000097:blood / Q000401:mortality*; D016757:Death, Sudden, Cardiac / Q000209:etiology; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011379:Prognosis; D013318:Stroke Volume / Q000502:physiology; D015996:Survival Rate; D020107:Troponin T / Q000097:blood
D015415:Biomarkers; C493408:FABP3 protein, human; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins; D020107:Troponin T; D020097:Natriuretic Peptide, Brain