Otaki Yoichiro, Watanabe Tetsu, Takahashi Hiroki, Hirayama Atushi, Narumi Taro, Kadowaki Shinpei, Honda Yuki, Arimoto Takanori, Shishido Tetsuro, Miyamoto Takuya, Konta Tsuneo, Shibata Yoko, Fukao Akira, Daimon Makoto, Ueno Yoshiyuki, Kato Takeo, Kayama Takamasa, Kubota Isao
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
Global Center of Excellence Program Study Group, Yamagata University School of Medicine, Yamagata, Japan.
PLoS One. 2014 May 21;9(5):e94834. doi: 10.1371/journal.pone.0094834. eCollection 2014.
Despite many recent advances in medicine, preventing the development of cardiovascular diseases remains a challenge. Heart-type fatty acid-binding protein (H-FABP) is a marker of ongoing myocardial damage and has been reported to be a useful indicator for future cardiovascular events. However, it remains to be determined whether H-FABP can predict all-cause and cardiovascular deaths in the general population.
This longitudinal cohort study included 3,503 subjects who participated in a community-based health checkup with a 7-year follow-up. Serum H-FABP was measured in registered subjects. The results demonstrated that higher H-FABP levels were associated with increasing numbers of cardiovascular risk factors, including hypertension, diabetes mellitus, obesity, and metabolic syndrome. There were 158 deaths during the follow-up period, including 50 cardiovascular deaths. Deceased subjects had higher H-FABP levels compared to surviving subjects. Multivariate Cox proportional hazard regression analysis revealed that H-FABP is an independent predictor of all-cause and cardiovascular deaths after adjustments for confounding factors. Subjects were divided into four quartiles according to H-FABP level, and Kaplan-Meier analysis demonstrated that the highest H-FABP quartile was associated with the greatest risks for all-cause and cardiovascular deaths. Net reclassification index and integrated discrimination index were significantly increased by addition of H-FABP to cardiovascular risk factors.
H-FABP level was increased in association with greater numbers of cardiovascular risk factors and was an independent risk factor for all-cause and cardiovascular deaths. H-FABP could be a useful indicator for the early identification of high-risk subjects in the general population.
尽管近年来医学取得了许多进展,但预防心血管疾病的发生仍然是一项挑战。心脏型脂肪酸结合蛋白(H-FABP)是正在发生的心肌损伤的标志物,据报道它是未来心血管事件的一个有用指标。然而,H-FABP是否能预测普通人群的全因死亡和心血管死亡仍有待确定。
这项纵向队列研究纳入了3503名参与社区健康检查并接受7年随访的受试者。对登记的受试者测量血清H-FABP。结果表明,较高的H-FABP水平与越来越多的心血管危险因素相关,包括高血压、糖尿病、肥胖和代谢综合征。随访期间有158例死亡,其中包括50例心血管死亡。与存活受试者相比,死亡受试者的H-FABP水平更高。多变量Cox比例风险回归分析显示,在对混杂因素进行调整后,H-FABP是全因死亡和心血管死亡的独立预测因子。根据H-FABP水平将受试者分为四个四分位数,Kaplan-Meier分析表明,H-FABP四分位数最高的组全因死亡和心血管死亡风险最大。将H-FABP添加到心血管危险因素中后,净重新分类指数和综合判别指数显著增加。
H-FABP水平随着心血管危险因素数量的增加而升高,是全因死亡和心血管死亡的独立危险因素。H-FABP可能是普通人群中早期识别高危受试者的有用指标。