Heart-type fatty acid-binding protein for risk assessment of chronic thromboembolic pulmonary hypertension.
Heart-type fatty acid-binding protein (H-FABP) is a reliable marker of myocardial injury and was recently identified as a predictor of outcome in acute pulmonary embolism. The aim of the present study was to investigate the prognostic value of H-FABP in chronic thromboembolic pulmonary hypertension (CTEPH). In total, 93 consecutive patients with CTEPH were studied. During long-term follow-up (median duration 1,260 days, interquartile range (IQR) 708-2,460 days), 46 (49%) patients had an adverse outcome, defined as CTEPH-related death, lung transplantation or persistent pulmonary hypertension after pulmonary endarterectomy (PEA). Baseline H-FABP levels in plasma ranged from 0.69-24.3 ng x mL(-1) (median (IQR) 3.41 (2.28-4.86) ng x mL(-1)). Cox regression analysis revealed a hazard ratio of 1.10 (95% confidence interval 1.04-1.18) for each increase of H-FABP by 1 ng x mL(-1), and continuous elevations of H-FABP emerged as an independent predictor of adverse outcome by multivariable analysis. PEA was performed in 52 patients and favourably affected the long-term outcome. Kaplan-Meier analysis revealed that patients with baseline H-FABP concentrations >2.7 ng x mL(-1), the median value of the biomarker in the surgically treated population, had a lower probability of event-free survival after PEA. Heart-type fatty acid-binding protein is a promising novel biomarker for risk stratification of patients with chronic thromboembolic pulmonary hypertension.
Lankeit
M
M
Dept of Cardiology and Pulmonology, University of Goettingen, D-37099 Goettingen, Germany.
Dellas
C
C
Panzenböck
A
A
Skoro-Sajer
N
N
Bonderman
D
D
Olschewski
M
M
Schäfer
K
K
Puls
M
M
Konstantinides
S
S
Lang
I M
IM
D000368:Aged; D015415:Biomarkers / Q000097:blood; D018572:Disease-Free Survival; D004691:Endarterectomy / Q000009:adverse effects; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood* / Q000601:surgery; D053208:Kaplan-Meier Estimate; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011651:Pulmonary Artery / Q000601:surgery; D011655:Pulmonary Embolism / Q000097:blood* / Q000601:surgery; D012307:Risk Factors; D012720:Severity of Illness Index
D015415:Biomarkers; D050556:Fatty Acid-Binding Proteins