Clinical InvestigationCongestive Heart FailureCorrelation of heart-type fatty acid–binding protein with mortality and echocardiographic data in patients with pulmonary embolism at intermediate risk
Section snippets
Study population and design
A total of 101 consecutive patients (57 women, 44 men, mean age 71 ± 12 years) with confirmed acute PE were prospectively included in this trial over a period of 36 months. Acute PE was confirmed by computed tomography scan. Pulmonary embolism was classified according to the new PE guidelines by the European Society of Cardiology in the following severity levels: high-risk and non–high-risk PE, whereas non–high risk is further classified in low-risk and intermediate-risk PE.15 Only patients
Baseline demographics
One hundred one patients were included in the study with a mean age of 70 ± 13 years. Heart-type fatty acid–binding protein was elevated (≥7 ng/mL) in 14 (14%) of the 101 patients. The baseline characteristics of the study population showed no statistical difference between the group with elevated and the group with normal H-FABP levels (Table I).
Clinical presentation
Of the 101 patients included, according to the inclusion criteria, none needed vasopressor support on admission, which would have been needed if
Discussion
Despite important advances in diagnosis and risk stratification, PE remains an underdiagnosed clinical entity with potentially life-threatening complications. Showing a correlation with in-hospital mortality, both echocardiography and biomarkers such as troponins have become indispensable tools in the management of patients with PE.7, 22 Recently, H-FABP has drawn attention as an additional biomarker showing a strong correlation to mortality in coronary patients,10, 13, 14 and in patients with
Conclusion
Heart-type fatty acid–binding protein is a promising and very early parameter showing a high correlation with both in-hospital 30-day and 6-month mortality in patients with acute PE at intermediate risk. It correlates very well with echocardiographic signs of RV dysfunction and therefore permits rapid risk assessment. Being an easy available test, it should be performed routinely on admission when PE is suspected to better risk-stratify patients.
Disclosures
Conflicts of interest: none.
No funding has been obtained for this study.
Acknowledgements
All authors significantly contributed to this work. The corresponding author states that she had full access to all of the data in the study and she takes full responsibility for the integrity of all of the data and the accuracy of the data analysis.
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Cited by (55)
Risk stratification of acute pulmonary embolism based on clinical parameters, H-FABP and multidetector CT
2018, International Journal of CardiologyCitation Excerpt :More importantly, H-FABP measurement on admission may help to identify normotensive patients at increased risk for PE-related short term complications [12–14,18–21]. In most studies, H-FABP measurements were performed by a time-consuming enzyme linked immunosorbent assay (ELISA) [12,14,16,17], which is not available for clinical routine, or by a semiquantitative bedside test [18,19,21]. A new immunoturbidimetric assay for H-FABP measurement was developed and has been tested in patients with acute coronary syndromes [22,23] and most recently in patients with acute PE.
Heart-type Fatty Acid Binding Protein in the Assessment of Acute Pulmonary Embolism
2016, American Journal of the Medical SciencesCitation Excerpt :In addition, the present study showed that H-FABP was associated with complicated in-hospital events. This result indicated that positive H-FABP was an indicator of severity and prognosis of patients with APE, which is consistent with the previous reports.11,18 The 6-month follow-up data demonstrated that complicated events were more in patients who were cTNI-positive than that in patients who were cTNI-negative on the first admission, and the similar result was observed for H-FABP, indicating that both the markers are associated with the 6-month prognosis of APE.
Heart-type fatty acid-binding protein and myocardial creatine kinase enable rapid risk stratification in normotensive patients with pulmonary embolism
2016, Journal of Critical CareCitation Excerpt :Consequentially, the total study population comprises 161 patients. Of these, 101 patients partially overlap with a previous study (similar design and in-/exclusion criteria) investigating the association between h-FABP levels and echocardiographic signs of RVD [27]. All included patients gave informed consent on admission and blood samples for the H-FABP test and the lab routine were collected.
Creatinine kinase isoenzyme-MB: A simple prognostic biomarker in patients with pulmonary embolism treated with thrombolytic therapy
2015, Journal of Critical CareCitation Excerpt :Myocardial injury occurs when h-FABP is released from the myocytes into the circulatory system. Previous studies have shown that there is a relationship between h-FABP levels and adverse clinical outcomes in patients with PE [27-29]. Dellas et al [27] reported that admission h-FABP level was an independent predictor of 30-day and long-term mortality in normotensive PE patients.
Risk stratification in acute pulmonary embolism with heart-type fatty acid-binding protein: A meta-analysis
2015, Journal of Critical Care
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Both authors equally contributed to this work.