Abnormal H-FABP levels (>6 ng/mL) at presentation strongly predicted a complicated course or 30-day mortality in patients with acute pulmonary embolism compared to normal levels (OR 71.45; P<0.0001).
Cohort (n=107)
Does heart-type fatty acid-binding protein (H-FABP) testing predict adverse outcomes and improve early risk stratification in patients with acute pulmonary embolism?
H-FABP is a strong independent predictor of 30-day adverse outcomes in acute pulmonary embolism, outperforming troponin T and NT-proBNP, and can identify low-risk patients even when echocardiography is abnormal.
Odds Ratio: 71.45
Absolute Event Rate: 41% vs 0%
p-value: p=<0.0001
AIMS: We investigated the value of a novel early biomarker, heart-type fatty acid-binding protein (H-FABP), in risk stratification of patients with acute pulmonary embolism (PE). METHODS AND RESULTS: We prospectively included 107 consecutive patients with confirmed PE. The endpoints were (i) PE-related death or major complications and (ii) overall 30-day mortality. Overall, 29 patients (27%) had abnormal (>6 ng/mL) H-FABP levels at presentation. Of those, 12 (41%) had a complicated course, whereas all patients with normal baseline H-FABP had a favourable 30-day outcome (OR, 71.45; P<0.0001). At multivariable analysis, H-FABP (P<0.0001), but not cardiac troponin T (P=0.13) or N-terminal pro-brain natriuretic peptide (P=0.36), predicted an adverse outcome. Evaluation of a strategy combining biomarker testing with echocardiography revealed that patients with a negative H-FABP test had an excellent prognosis regardless of echocardiographic findings. In contrast, patients with a positive H-FABP test had a complication rate of 23.1% even in the presence of a normal echocardiogram, and this rose to 57.1% if echocardiography also demonstrated right ventricular dysfunction (OR vs. a negative H-FABP test, 5.6 and 81.4, respectively). CONCLUSION: H-FABP is a promising early indicator of right ventricular injury and dysfunction in acute PE. It may help optimize risk stratification algorithms and treatment strategies.
Puls et al. (Wed,) conducted a cohort in Acute pulmonary embolism (n=107). Abnormal H-FABP levels (>6 ng/mL) vs. Normal H-FABP levels was evaluated on PE-related death or major complications and overall 30-day mortality (OR 71.45, p=<0.0001). Abnormal H-FABP levels (>6 ng/mL) at presentation strongly predicted a complicated course or 30-day mortality in patients with acute pulmonary embolism compared to normal levels (OR 71.45; P<0.0001).