title: The Prognostic Value of Serum Levels of Heart-Type Fatty Acid Binding Protein and High Sensitivity C-Reactive Protein in Patients With Increased Levels of Amino-Terminal Pro-B Type Natriuretic Peptide.
abstract: BACKGROUND
  Amino-terminal pro-B type natriuretic peptide (NT-proBNP) is a well-established prognostic factor in heart failure (HF). However, numerous causes may lead to elevations in NT-proBNP, and thus, an increased NT-proBNP level alone is not sufficient to predict outcome. The aim of this study was to evaluate the utility of two acute response markers, high sensitivity C-reactive protein (hsCRP) and heart-type fatty acid binding protein (H-FABP), in patients with an increased NT-proBNP level.
  
  
  METHODS
  The 278 patients were classified into three groups by etiology: 1) acute coronary syndrome (ACS) (n=62), 2) non-ACS cardiac disease (n=156), and 3) infectious disease (n=60). Survival was determined on day 1, 7, 14, 21, 28, 60, 90, 120, and 150 after enrollment.
  
  
  RESULTS
  H-FABP (P<0.001), NT-proBNP (P=0.006), hsCRP (P<0.001) levels, and survival (P<0.001) were significantly different in the three disease groups. Patients were divided into three classes by using receiver operating characteristic curves for NT-proBNP, H-FABP, and hsCRP. Patients with elevated NT-proBNP (≥3,856 pg/mL) and H-FABP (≥8.8 ng/mL) levels were associated with higher hazard ratio for mortality (5.15 in NT-proBNP and 3.25 in H-FABP). Area under the receiver operating characteristic curve analysis showed H-FABP was a better predictor of 60-day mortality than NT-proBNP.
  
  
  CONCLUSIONS
  The combined measurement of H-FABP with NT-proBNP provides a highly reliable means of short-term mortality prediction for patients hospitalized for ACS, non-ACS cardiac disease, or infectious disease.
authors.affiliation: Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Ji Hun
authors.initials: JH
authors.lastname: Jeong
authors.affiliation: Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Yiel Hea
authors.initials: YH
authors.lastname: Seo
authors.affiliation: Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Jeong Yeal
authors.initials: JY
authors.lastname: Ahn
authors.affiliation: Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Kyung Hee
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Ja Young
authors.initials: JY
authors.lastname: Seo
authors.affiliation: Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Moon Jin
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Hwan Tae
authors.initials: HT
authors.lastname: Lee
authors.affiliation: Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon, Korea. pwpark@gilhospital.com.
authors.forename: Pil Whan
authors.initials: PW
authors.lastname: Park
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve
chemical_list: D015415:Biomarkers; C493408:FABP3 protein, human; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein
keywords: Amino-terminal pro-B type natriuretic peptide; Heart-type fatty acid binding protein; High sensitivity C-reactive protein; Prognostic marker