Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Cardiology Division, Department of Internal Medicine, Miaoli General Hospital, Ministry of Health and Welfare, Miaoli, Taiwan.
Sci Rep. 2018 Sep 26;8(1):14410. doi: 10.1038/s41598-018-32210-x.
To investigate the prognostic value of heart-type fatty acid binding protein (H-FABP) in patients with stable coronary heart disease (SCHD). A total of 1,071 patients with SCHD were prospectively enrolled in this Taiwan multicenter registry study, followed for 24 months. The cut-off value of H-FABP, 4.143 pg/mL, was determined using receiver operating characteristic curves. The primary cardiovascular (CV) outcome was composite CV events, defined as cardiovascular or cerebrovascular death, myocardial infarction (MI), stroke, angina related-hospitalization, PAOD-related hospitalization and heart failure. Secondary outcomes included CV or cerebrovascular death, nonfatal MI, nonfatal stroke, and acute heart failure-related hospitalization. We found that the high H-FABP group had more than a two-fold higher rate of primary CV outcomes than the low H-FABP group (32.36% vs. 15.78%, p < 0.001). Eleven patients (4.82%) of the high H-FABP group died during the 24 months of follow-up, compared to only one patient (0.12%) in the low H-FABP group. The acute heart failure-related hospitalization rate was also significantly higher in the high H-FABP group (3.5% vs. 0.95%, p < 0.005). The results remained significant after adjusting for baseline covariates. In conclusion, H-FABP was an independent predictor for CV outcomes in the patients with SCHD, mainly in CV death and acute heart failure-related hospitalization.
探讨心脏型脂肪酸结合蛋白(H-FABP)在稳定性冠心病(SCHD)患者中的预后价值。
这项台湾多中心注册研究前瞻性纳入了 1071 例 SCHD 患者,随访 24 个月。采用受试者工作特征曲线确定 H-FABP 的截断值为 4.143pg/ml。主要心血管(CV)结局为复合 CV 事件,定义为心血管或脑血管死亡、心肌梗死(MI)、卒中等,次要结局包括 CV 或脑血管死亡、非致命性 MI、非致命性卒中和急性心力衰竭相关住院治疗。
我们发现,H-FABP 水平较高组的主要 CV 结局发生率是 H-FABP 水平较低组的两倍以上(32.36%比 15.78%,p<0.001)。在 24 个月的随访期间,H-FABP 水平较高组中有 11 例(4.82%)患者死亡,而 H-FABP 水平较低组中仅有 1 例(0.12%)患者死亡。H-FABP 水平较高组急性心力衰竭相关住院治疗的发生率也显著更高(3.5%比 0.95%,p<0.005)。在校正基线协变量后,结果仍然具有统计学意义。
H-FABP 是 SCHD 患者 CV 结局的独立预测因子,主要与 CV 死亡和急性心力衰竭相关住院治疗有关。