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.
10.3343/alm.2016.36.5.420
- Author:
Ji Hun JEONG
1
;
Yiel Hea SEO
;
Jeong Yeal AHN
;
Kyung Hee KIM
;
Ja Young SEO
;
Moon Jin KIM
;
Hwan Tae LEE
;
Pil Whan PARK
Author Information
1. Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon, Korea. pwpark@gilhospital.com
- Publication Type:Original Article
- Keywords:
Amino-terminal pro-B type natriuretic peptide;
Heart-type fatty acid binding protein;
High sensitivity C-reactive protein;
Prognostic marker
- MeSH:
Acute Coronary Syndrome/blood/*diagnosis/mortality;
Aged;
Area Under Curve;
Biomarkers/blood;
C-Reactive Protein/*analysis;
Fatty Acid-Binding Proteins/*blood;
Female;
Humans;
Kaplan-Meier Estimate;
Male;
Middle Aged;
Natriuretic Peptide, Brain/*blood;
Peptide Fragments/*blood;
Prognosis;
Proportional Hazards Models;
ROC Curve
- From:Annals of Laboratory Medicine
2016;36(5):420-426
- CountryRepublic of Korea
- Language:English
-
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.