title: Elevated levels of both cardiomyocyte membrane and myofibril damage markers predict adverse outcomes in patients with chronic heart failure.
abstract: BACKGROUND
  Recent studies have shown the presence of ongoing myocardial damage in patients with chronic heart failure (CHF) detected by myofibril and membrane damage markers, cardiac troponin T (TnT) and heart-type fatty acid-binding protein (H-FABP), which identifies patients at increased risk of a future cardiac event (CE: death or rehospitalization because of worsening CHF). There is a difference between TnT and H-FABP in their release kinetics following myocardial damage.
  
  
  RESULTS
  TnT and H-FABP were measured in 103 patients with CHF and in 31 controls. Patients were classified into 4 groups based on detectable (>or=0.01 ng/ml) or undetectable TnT (TnT+ or TnT-) and H-FABP >or= or <4.5 ng/ml (mean + 2 standard deviations in controls) (high-H-FABP or low-H-FABP). Kaplan-Meier analysis showed that the CE-free rate (n=43) was significantly lower in patients with TnT+ and high-H-FABP than in patients in the other 3 groups (patients with TnT+ and low-H-FABP, TnT- and high-H-FABP, and TnT- and low-H-FABP; p=0.02, p=0.001 and p=0.0002, respectively). In stepwise multivariate Cox proportional hazard analysis, TnT+ (p=0.01) and high-H-FABP (p=0.04) were independent predictors of future CE.
  
  
  CONCLUSIONS
  Elevated levels of both TnT and H-FABP predict adverse outcomes in CHF patients.
authors: Department of Cardiology and Clinical Laboratory, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan. setsuta@cick.jp
authors: Koichi
authors: K
authors: Setsuta
authors: Yoshihiko
authors: Y
authors: Seino
authors: Yasuyuki
authors: Y
authors: Kitahara
authors: Masato
authors: M
authors: Arau
authors: Taminori
authors: T
authors: Ohbayashi
authors: Teruo
authors: T
authors: Takano
authors: Kyoichi
authors: K
authors: Mizuno
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002462:Cell Membrane / Q000378:metabolism; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D006333:Heart Failure / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D032383:Myocytes, Cardiac / Q000378:metabolism; D009210:Myofibrils / Q000378:metabolism; D011379:Prognosis; D016016:Proportional Hazards Models; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; C493408:FABP3 protein, human; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins; D020107:Troponin T