Clinical significance of the measurements of urinary liver-type fatty acid binding protein levels in patients with acute coronary syndrome.
BACKGROUND
Recently, much attention has been focused on cardio-renal interaction. Urinary liver-type fatty acid binding protein (U-L-FABP), which is produced in the proximal tubule by renal hypoxia and oxidative stress, has been identified as a useful marker for diagnosis of acute kidney disease and a predictor of future events in chronic kidney disease. However, the clinical significance of U-L-FABP measurements in patients with acute coronary syndrome (ACS) has not been completely evaluated.


RESULTS
This study included 50 consecutive patients with ACS [37 with acute myocardial infarction (AMI) and 13 with unstable angina pectoris (UAP)] and 47 subjects without coronary artery disease (control group). U-L-FABP levels, urinary albumin (U-Alb), and other serum parameters were measured at admission and at 24 h after percutaneous coronary intervention.


RESULTS
U-L-FABP levels in patients with AMI were significantly higher (p=0.0019), than in control subjects, while patients with UAP did not exhibit such an increase. U-L-FABP levels at admission were positively correlated with brain natriuretic protein levels (p=0.001) and duration of hospitalization (p=0.025). At follow-up angiography, patients with restenosis had significantly higher U-L-FABP (p=0.047) and U-Alb levels (p<0.0001) than those without restenosis. After a median follow-up of 42 months, U-L-FABP levels at second measurement in patients with major adverse cardiocerebrovascular events (MACCEs) were significantly higher than those in patients without MACCEs (p=0.028). After adjusting for confounding factors, high U-L-FABP levels at second measurement were found to be independent factors for MACCEs (p=0.019).


CONCLUSIONS
These data suggest that patients with ACS, especially those with AMI, have high U-L-FABP levels, and that U-L-FABP measurements may be useful in identifying high-risk patients for future cardiovascular events after ACS.
Department of Cardiovascular Medicine, Juntendo University School of Medicine, Tokyo, Japan.
Rie
R
Matsumori
Kazunori
K
Shimada
Takashi
T
Kiyanagi
Makoto
M
Hiki
Kosuke
K
Fukao
Kuniaki
K
Hirose
Hiromichi
H
Ohsaka
Tetsuro
T
Miyazaki
Atsumi
A
Kume
Atsushi
A
Yamada
Atsutoshi
A
Takagi
Hirotoshi
H
Ohmura
Katsumi
K
Miyauchi
Hiroyuki
H
Daida
D054058:Acute Coronary Syndrome / Q000097:blood / Q000628:therapy / Q000652:urine*; D015415:Biomarkers / Q000652:urine*; D017115:Catheter Ablation; D050556:Fatty Acid-Binding Proteins / Q000652:urine*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000652:urine; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use
D015415:Biomarkers; D050556:Fatty Acid-Binding Proteins; D010975:Platelet Aggregation Inhibitors