Prognostic value of myocardial damage markers in patients with chronic heart failure with atrial fibrillation.
OBJECTIVE
The aim of the present study was to examine the relationship between myocardial damage caused by atrial fibrillation (AF) and subsequent cardiovascular events in AF patients with chronic heart failure (CHF).


RESULTS
We measured the serum levels of heart-type fatty acid binding protein (H-FABP) and high-sensitivity troponin T in 402 consecutive CHF patients with chronic AF (CHF-AF, n=201) or sinus rhythm (CHF-SR, n=201). The patients with CHF-AF had higher H-FABP and troponin T levels than those with CHF-SR. In order to examine the prognostic value of myocardial damage markers in CHF-AF and CHF-SR patients, we followed the above patients and analyzed their clinical outcomes. A multivariate Cox proportional hazard analysis revealed that both the serum H-FABP and troponin T levels independently predicted subsequent cardiovascular events. A Kaplan-Meier analysis demonstrated that the rate of cardiovascular events was higher in the patients with elevated H-FABP and troponin T levels. The optimal cut-off values for the myocardial damage markers of cardiovascular events were higher in the CHF-AF patients than in the CHF-SR patients (H-FABP, 5.4 vs. 4.6 ng/mL and troponin T, 0.030 vs. 0.013 ng/mL).


CONCLUSIONS
Myocardial damage advances in association with the presence of AF and is associated with subsequent cardiovascular events in both CHF-AF and CHF-SR patients. In this study, the cut-off values for the myocardial damage markers were higher in the CHF-AF patients than in the CHF-SR patients.
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Japan.
Yoichiro
Y
Otaki
Takanori
T
Arimoto
Hiroki
H
Takahashi
Shinpei
S
Kadowaki
Daisuke
D
Ishigaki
Taro
T
Narumi
Yuki
Y
Honda
Tadateru
T
Iwayama
Satoshi
S
Nishiyama
Tetsuro
T
Shishido
Takehiko
T
Miyashita
Takuya
T
Miyamoto
Tetsu
T
Watanabe
Isao
I
Kubota
D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D009202:Cardiomyopathies / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008297:Male; D009206:Myocardium / Q000378:metabolism*; D011379:Prognosis; D012189:Retrospective Studies; 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