Key result
Elevated H-FABP and troponin T independently predicted cardiovascular events in CHF patients, with higher optimal cut-offs in AF vs sinus rhythm (H-FABP 5.4 vs 4.6 ng/mL; TnT 0.030 vs 0.013 ng/mL).
Why the study?
Do elevated serum levels of H-FABP and high-sensitivity troponin T predict cardiovascular events in patients with chronic heart failure with and without atrial fibrillation?
Cohort (n=402)
Do elevated serum levels of H-FABP and high-sensitivity troponin T predict cardiovascular events in patients with chronic heart failure with and without atrial fibrillation?
May inform risk stratification in CHF; hypothesis-generating and should not yet change practice.
OBJECTIVE: The aim of the present study was to examine the relationship between myocardial damage caused by atrial fibrillation (AF) and subsequent cardiovascular events in AF patients with chronic heart failure (CHF). METHODS AND RESULTS: We measured the serum levels of heart-type fatty acid binding protein (H-FABP) and high-sensitivity troponin T in 402 consecutive CHF patients with chronic AF (CHF-AF, n=201) or sinus rhythm (CHF-SR, n=201). The patients with CHF-AF had higher H-FABP and troponin T levels than those with CHF-SR. In order to examine the prognostic value of myocardial damage markers in CHF-AF and CHF-SR patients, we followed the above patients and analyzed their clinical outcomes. A multivariate Cox proportional hazard analysis revealed that both the serum H-FABP and troponin T levels independently predicted subsequent cardiovascular events. A Kaplan-Meier analysis demonstrated that the rate of cardiovascular events was higher in the patients with elevated H-FABP and troponin T levels. The optimal cut-off values for the myocardial damage markers of cardiovascular events were higher in the CHF-AF patients than in the CHF-SR patients (H-FABP, 5.4 vs. 4.6 ng/mL and troponin T, 0.030 vs. 0.013 ng/mL). CONCLUSION: Myocardial damage advances in association with the presence of AF and is associated with subsequent cardiovascular events in both CHF-AF and CHF-SR patients. In this study, the cut-off values for the myocardial damage markers were higher in the CHF-AF patients than in the CHF-SR patients.
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Otaki et al. (2014) conducted a cohort in Chronic heart failure with atrial fibrillation or sinus rhythm (n=402). Serum H-FABP and high-sensitivity troponin T vs. Lower biomarker levels / Sinus rhythm was evaluated on Subsequent cardiovascular events. Elevated H-FABP and troponin T independently predicted cardiovascular events in CHF patients, with higher optimal cut-offs in AF vs sinus rhythm (H-FABP 5.4 vs 4.6 ng/mL; TnT 0.030 vs 0.013 ng/mL).
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