Limits...
The Prognostic Value of Serum Levels of Heart-Type Fatty Acid Binding Protein and High Sensitivity C-Reactive Protein in Patients With Increased Levels of Amino-Terminal Pro-B Type Natriuretic Peptide

View Article: PubMed Central - PubMed

ABSTRACT

Background: Amino-terminal pro-B type natriuretic peptide (NT-proBNP) is a well-established prognostic factor in heart failure (HF). However, numerous causes may lead to elevations in NT-proBNP, and thus, an increased NT-proBNP level alone is not sufficient to predict outcome. The aim of this study was to evaluate the utility of two acute response markers, high sensitivity C-reactive protein (hsCRP) and heart-type fatty acid binding protein (H-FABP), in patients with an increased NT-proBNP level.

Methods: The 278 patients were classified into three groups by etiology: 1) acute coronary syndrome (ACS) (n=62), 2) non-ACS cardiac disease (n=156), and 3) infectious disease (n=60). Survival was determined on day 1, 7, 14, 21, 28, 60, 90, 120, and 150 after enrollment.

Results: H-FABP (P<0.001), NT-proBNP (P=0.006), hsCRP (P<0.001) levels, and survival (P<0.001) were significantly different in the three disease groups. Patients were divided into three classes by using receiver operating characteristic curves for NT-proBNP, H-FABP, and hsCRP. Patients with elevated NT-proBNP (≥3,856 pg/mL) and H-FABP (≥8.8 ng/mL) levels were associated with higher hazard ratio for mortality (5.15 in NT-proBNP and 3.25 in H-FABP). Area under the receiver operating characteristic curve analysis showed H-FABP was a better predictor of 60-day mortality than NT-proBNP.

Conclusions: The combined measurement of H-FABP with NT-proBNP provides a highly reliable means of short-term mortality prediction for patients hospitalized for ACS, non-ACS cardiac disease, or infectious disease.

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier analysis of survival in patients in the ACS group (n=62) stratified into three groups based on (A) NT-proBNP, (B) H-FABP, and (C) hsCRP levels. Kaplan-Meier analysis of survival in the non-ACS group (n=156) classified by (D) NT-proBNP, (E) H-FABP, and (F) hsCRP levels. Kaplan-Meier analysis of survival in patients with infection & sepsis (n=60) for (G) NT-proBNP, (H) H-FABP, and (I) hsCRP levels.Abbreviations: ACS, acute coronary syndrome; NT-ProBNP, amino-terminal pro-B type natriuretic peptide; H-FABP, heart-type fatty acid binding protein; hsCRP, high sensitivity C-reactive protein.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4940484&req=5

Figure 1: Kaplan-Meier analysis of survival in patients in the ACS group (n=62) stratified into three groups based on (A) NT-proBNP, (B) H-FABP, and (C) hsCRP levels. Kaplan-Meier analysis of survival in the non-ACS group (n=156) classified by (D) NT-proBNP, (E) H-FABP, and (F) hsCRP levels. Kaplan-Meier analysis of survival in patients with infection & sepsis (n=60) for (G) NT-proBNP, (H) H-FABP, and (I) hsCRP levels.Abbreviations: ACS, acute coronary syndrome; NT-ProBNP, amino-terminal pro-B type natriuretic peptide; H-FABP, heart-type fatty acid binding protein; hsCRP, high sensitivity C-reactive protein.

Mentions: Kaplan-Meier curves showed that the elevated serum NT-proBNP and H-FABP levels were prognostic markers of mortality over 150 days in each disease group (Fig. 1), and mortality rates increased in proportion to NT-proBNP (Fig. 1A, D, G) and H-FABP levels (Fig. 1B, E, H). However, an elevated hsCRP level only affected mortality in the cardiac disease groups (Fig. 1C, F) over 150 days, and the mortality rate increased in proportion to the hsCRP level.


The Prognostic Value of Serum Levels of Heart-Type Fatty Acid Binding Protein and High Sensitivity C-Reactive Protein in Patients With Increased Levels of Amino-Terminal Pro-B Type Natriuretic Peptide
Kaplan-Meier analysis of survival in patients in the ACS group (n=62) stratified into three groups based on (A) NT-proBNP, (B) H-FABP, and (C) hsCRP levels. Kaplan-Meier analysis of survival in the non-ACS group (n=156) classified by (D) NT-proBNP, (E) H-FABP, and (F) hsCRP levels. Kaplan-Meier analysis of survival in patients with infection & sepsis (n=60) for (G) NT-proBNP, (H) H-FABP, and (I) hsCRP levels.Abbreviations: ACS, acute coronary syndrome; NT-ProBNP, amino-terminal pro-B type natriuretic peptide; H-FABP, heart-type fatty acid binding protein; hsCRP, high sensitivity C-reactive protein.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940484&req=5

Figure 1: Kaplan-Meier analysis of survival in patients in the ACS group (n=62) stratified into three groups based on (A) NT-proBNP, (B) H-FABP, and (C) hsCRP levels. Kaplan-Meier analysis of survival in the non-ACS group (n=156) classified by (D) NT-proBNP, (E) H-FABP, and (F) hsCRP levels. Kaplan-Meier analysis of survival in patients with infection & sepsis (n=60) for (G) NT-proBNP, (H) H-FABP, and (I) hsCRP levels.Abbreviations: ACS, acute coronary syndrome; NT-ProBNP, amino-terminal pro-B type natriuretic peptide; H-FABP, heart-type fatty acid binding protein; hsCRP, high sensitivity C-reactive protein.
Mentions: Kaplan-Meier curves showed that the elevated serum NT-proBNP and H-FABP levels were prognostic markers of mortality over 150 days in each disease group (Fig. 1), and mortality rates increased in proportion to NT-proBNP (Fig. 1A, D, G) and H-FABP levels (Fig. 1B, E, H). However, an elevated hsCRP level only affected mortality in the cardiac disease groups (Fig. 1C, F) over 150 days, and the mortality rate increased in proportion to the hsCRP level.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Amino-terminal pro-B type natriuretic peptide (NT-proBNP) is a well-established prognostic factor in heart failure (HF). However, numerous causes may lead to elevations in NT-proBNP, and thus, an increased NT-proBNP level alone is not sufficient to predict outcome. The aim of this study was to evaluate the utility of two acute response markers, high sensitivity C-reactive protein (hsCRP) and heart-type fatty acid binding protein (H-FABP), in patients with an increased NT-proBNP level.

Methods: The 278 patients were classified into three groups by etiology: 1) acute coronary syndrome (ACS) (n=62), 2) non-ACS cardiac disease (n=156), and 3) infectious disease (n=60). Survival was determined on day 1, 7, 14, 21, 28, 60, 90, 120, and 150 after enrollment.

Results: H-FABP (P<0.001), NT-proBNP (P=0.006), hsCRP (P<0.001) levels, and survival (P<0.001) were significantly different in the three disease groups. Patients were divided into three classes by using receiver operating characteristic curves for NT-proBNP, H-FABP, and hsCRP. Patients with elevated NT-proBNP (≥3,856 pg/mL) and H-FABP (≥8.8 ng/mL) levels were associated with higher hazard ratio for mortality (5.15 in NT-proBNP and 3.25 in H-FABP). Area under the receiver operating characteristic curve analysis showed H-FABP was a better predictor of 60-day mortality than NT-proBNP.

Conclusions: The combined measurement of H-FABP with NT-proBNP provides a highly reliable means of short-term mortality prediction for patients hospitalized for ACS, non-ACS cardiac disease, or infectious disease.

No MeSH data available.


Related in: MedlinePlus