Document Detail


Heart-type fatty acid-binding protein permits early risk stratification of pulmonary embolism.
MedLine Citation:
PMID:  17127709     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Miriam Puls; Claudia Dellas; Mareike Lankeit; Manfred Olschewski; Lutz Binder; Anette Geibel; Christian Reiner; Katrin Schäfer; Gerd Hasenfuss; Stavros Konstantinides
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Publication Detail:
Type:  Journal Article     Date:  2006-11-24
Journal Detail:
Title:  European heart journal     Volume:  28     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-31     Completed Date:  2007-11-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  224-9     Citation Subset:  IM    
Affiliation:
Department of Cardiology and Pulmonology, University of Goettingen, Germany.
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MeSH Terms
Descriptor/Qualifier:
Biological Markers / metabolism
Enzyme-Linked Immunosorbent Assay
Fatty Acid-Binding Proteins / metabolism*
Female
Humans
Male
Middle Aged
Natriuretic Peptide, Brain / metabolism
Peptide Fragments / metabolism
Prospective Studies
Pulmonary Embolism / etiology*
Risk Assessment
Risk Factors
Troponin / metabolism
Chemical
Reg. No./Substance:
0/Biological Markers; 0/FABP3 protein, human; 0/Fatty Acid-Binding Proteins; 0/Peptide Fragments; 0/Troponin; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain
Comments/Corrections
Comment In:
Eur Heart J. 2007 Jan;28(2):146-7   [PMID:  17208938 ]

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