title: Diabetic patients have increased perioperative cardiac risk in heart-type fatty acid-binding protein-based assessment.
abstract: OBJECTIVE
  To test the potential role of heart-type fatty acid-binding protein (H-FABP) in detecting increased perioperative cardiac risk in comparison with cardiac troponin I (cTnI) in the early postoperative period.
  
  
  METHODS
  Sixty-seven patients who had clinical risk factors and underwent elective intermediate - or high-risk noncardiac surgery were included in this study. Serum specimens were analyzed for H-FABP and cTnI levels before and at 8 h after surgery. None of the patients had chest pain; 27 had a history of ischemic heart disease, 3 of heart failure, 5 of cerebrovascular diseases, 40 of diabetes and 46 of hypertension.
  
  
  RESULTS
  The mean duration of the operations was 2.33 ± 1.27 h (range 1-6). In the postoperative period, 27 (40.3%) patients had increased H-FABP levels (≥7.5 ng/ml); the median preoperative serum H-FABP level was 0.13 ng/ml (<0.1-5.9) and the median postoperative H-FABP level was 6.86 ng/ml (<0.1-13.7). Only 1 (1.5%) patient had cTnI >0.1 µg/l during the postoperative period. Correlation analysis revealed that the presence of diabetes was associated with an increased H-FABP level (r = 0.30, p = 0.01). Of the 27 patients with H-FABP ≥7.5 ng/ml, 21 (87%) had diabetes. There was no significant correlation with other clinical risk factors, type or duration of surgery.
  
  
  CONCLUSIONS
  The H-FABP levels significantly increased in the postoperative period. Most patients with increased postoperative H-FABP levels were diabetic. High H-FABP levels could alert clinicians to increased perioperative cardiovascular risk and could prevent underdiagnosis, especially in diabetic patients.
authors.affiliation: Cardiology Clinic, Ministry of Health, Birecik State Hospital, Sanliurfa, Turkey.
authors.forename: Munevver
authors.initials: M
authors.lastname: Sari
authors.forename: Harun
authors.initials: H
authors.lastname: Kilic
authors.forename: Ozlem Karakurt
authors.initials: OK
authors.lastname: Ariturk
authors.forename: Nuray
authors.initials: N
authors.lastname: Yazihan
authors.forename: Ramazan
authors.initials: R
authors.lastname: Akdemir
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood*; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000097:blood*; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D006801:Humans; D006973:Hypertension; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D018570:Risk Assessment; D012307:Risk Factors; D019210:Troponin I / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D050556:Fatty Acid-Binding Proteins; D019210:Troponin I