Ischemic biomarker heart-type fatty acid binding protein hFABP in acute heart failure - diagnostic and prognostic insights compared to NT-proBNP and troponin IReportar como inadecuado




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BMC Cardiovascular Disorders

, 15:50

First Online: 14 June 2015Received: 10 January 2015Accepted: 21 April 2015DOI: 10.1186-s12872-015-0026-0

Cite this article as: Hoffmann, U., Espeter, F., Weiß, C. et al. BMC Cardiovasc Disord 2015 15: 50. doi:10.1186-s12872-015-0026-0

Abstract

BackgroundTo evaluate diagnostic and long-term prognostic values of hFABP compared to NT-proBNP and troponin I TnI in patients presenting to the emergency department ED suspected of acute heart failure AHF.

Methods401 patients with acute dyspnea or peripheral edema, 122 suffering from AHF, were prospectively enrolled and followed up to 5 years. hFABP combined with NT-proBNP versus NT-proBNP alone was tested for AHF diagnosis. Prognostic value of hFABP versus TnI was evaluated in models predicting all-cause mortality ACM and AHF related rehospitalization AHF-RH at 1 and 5 years, including 11 conventional risk factors plus NT-proBNP.

ResultsAdditional hFABP measurements improved diagnostic specificity and positive predictive value PPV of sole NT-proBNP testing at the cutoff <300 ng-l to -rule out- AHF. Highest hFABP levels 4th quartile were associated with increased ACM hazard ratios HR: 2.1–2.5; p = 0.04 and AHF-RH risk at 5 years HR 2.8–8.3, p = 0.001. ACM was better characterized in prognostic models including TnI, whereas AHF-RH was better characterized in prognostic models including hFABP. Cox analyses revealed a 2 % increase of ACM risk and 3–7 % increase of AHF-RH risk at 5 years by each unit increase of hFABP of 10 ng-ml.

ConclusionsCombining hFABP plus NT-proBNP <300 ng-l only improves diagnostic specificity and PPV to rule out AHF. hFABP may improve prognosis for long-term AHF-RH, whereas TnI may improve prognosis for ACM.

Trial registrationClinicalTrials.gov identifier: NCT00143793.

KeywordsAcute heart failure hFABP Mortality NT-proBNP Prognosis Rehospitalisation Troponin I  Download fulltext PDF



Autor: Ursula Hoffmann - Florian Espeter - Christel Weiß - Parviz Ahmad-Nejad - Siegfried Lang - Martina Brueckmann - Ibrahim Aki

Fuente: https://link.springer.com/







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