title: Elevation of urinary liver-type fatty acid binding protein after cardiac catheterization related to cardiovascular events.
abstract: OBJECTIVE
  Contrast medium (CM) induces tubular hypoxia via endothelial damage due to direct cytotoxicity or viscosity. Urinary liver-type fatty acid binding protein (L-FABP) increases along with tubular hypoxia and may be a detector of systemic circulation injury. The aim of this study was to evaluate the clinical usefulness of detecting increases in urinary L-FABP levels due to administration of CM, as a prognostic biomarker for cardiovascular disease in patients without occurrence of CM-induced nephropathy undergoing cardiac catheterization procedure (CCP).
  
  
  METHODS
  Retrospective longitudinal analyses of the relationship between urinary L-FABP levels and occurrence of cardiovascular events were performed (n=29). Urinary L-FABP was measured by ELISA before CCP, and at 6, 12, 24, and 48 hours after CCP.
  
  
  RESULTS
  Urinary L-FABP levels were significantly higher at 12 hours (P<0.05) and 24 hours (P<0.005) after CCP compared with before CCP, only in the patients with occurrence of cardiovascular events (n=17), but not in those without cardiovascular events (n=12). The parameter with the largest area under the curve (0.816) for predicting the occurrence of cardiovascular events was the change in urinary L-FABP at 24 hours after CCP. The difference in urinary L-FABP levels (ΔL-FABP ≥11.0 μg/g creatinine) between before CCP and at 24 hours after CCP was a risk factor for the occurrence of cardiovascular events (hazard ratio, 4.93; 95% confidence interval, 1.27-19.13; P=0.021).
  
  
  CONCLUSIONS
  Measurement of urinary L-FABP before CCP and at 24 hours after CCP in patients with mild to moderate renal dysfunction may be an important indicator for risk stratification of onset of cardiovascular events.
authors: Department of Nephrology and Hypertension, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan ; Department of Anatomy, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
authors: Atsuko
authors: A
authors: Kamijo-Ikemori
authors: Department of Cardiology, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
authors: Nobuyuki
authors: N
authors: Hashimoto
authors: Department of Nephrology and Hypertension, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
authors: Takeshi
authors: T
authors: Sugaya
authors: Department of Nephrology and Hypertension, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
authors: Katsuomi
authors: K
authors: Matsui
authors: Department of Nephrology and Hypertension, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
authors: Mikako
authors: M
authors: Hisamichi
authors: Department of Nephrology and Hypertension, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
authors: Yugo
authors: Y
authors: Shibagaki
authors: Department of Cardiology, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
authors: Fumihiko
authors: F
authors: Miyake
authors: Department of Nephrology and Hypertension, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
authors: Kenjiro
authors: K
authors: Kimura
keywords: L-FABP; cardiovascular event; chronic kidney disease; contrast medium; renal dysfunction; urinary biomarker; urinary liver-type fatty acid binding protein