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Elevated Heart-Type Fatty Acid-Binding Protein Levels on Admission Predict an Adverse Outcome in Normotensive Patients With Acute Pulmonary Embolism
- Source :
- Journal of the American College of Cardiology. (19):2150-2157
- Publisher :
- American College of Cardiology Foundation. Published by Elsevier Inc.
-
Abstract
- OBJECTIVES: We assessed the predictive value of heart-type fatty acid-binding protein (H-FABP) in normotensive patients with acute pulmonary embolism (PE). BACKGROUND: Risk stratification of initially normotensive patients with PE on the basis of right ventricular dysfunction or injury remains controversial. Previous studies investigating biomarkers or imaging modalities included unselected patients, some of whom presented with cardiogenic shock. METHODS: We included 126 consecutive normotensive patients with confirmed PE. Complicated 30-day outcome was defined as death, resuscitation, intubation, or use of catecholamines. Long-term survival was assessed by follow-up clinical examination. RESULTS: During the first 30 days, 9 (7%) patients suffered complications. These patients had higher baseline H-FABP values (median, 11.2 ng/ml [interquartile range: 8.0 to 36.8 ng/ml]) compared with patients with an uncomplicated course (3.4 ng/ml [2.1 to 4.9 ng/ml]; p < 0.001). H-FABP values were above the calculated (by receiver operating characteristic curve analysis) cutoff value of 6 ng/ml in 29 patients. Eight (28%) of them suffered complications versus 1 of 97 patients with low H-FABP (negative predictive value, 99%; p < 0.001). By logistic regression, elevated (> or =6 ng/ml) H-FABP was associated with a 36.6-fold increase in the death or complication risk. The combination of H-FABP with tachycardia was a particularly useful prognostic indicator. H-FABP also predicted long-term mortality over 499 (interquartile range: 204 to 1,166) days (hazard ratio: 3.6; 95% confidence interval: 1.6 to 8.2; p = 0.003). CONCLUSIONS: The H-FABP might be a useful biomarker for risk stratification of normotensive patients with acute PE. peerReviewed
- Subjects :
- Resuscitation
medicine.medical_specialty
pulmonary embolism
Blood Pressure
risk stratification
030204 cardiovascular system & hematology
Fatty Acid-Binding Proteins
Risk Assessment
Cohort Studies
03 medical and health sciences
Patient Admission
0302 clinical medicine
Predictive Value of Tests
Interquartile range
Internal medicine
Humans
Medicine
030212 general & internal medicine
Survival analysis
Aged
Aged, 80 and over
business.industry
Cardiogenic shock
Reproducibility of Results
heart-type fatty acid-binding protein
prognosis
Middle Aged
Prognosis
medicine.disease
Survival Analysis
3. Good health
Pulmonary embolism
Surgery
Blood pressure
ROC Curve
Predictive value of tests
Heart-type fatty acid binding protein
Cardiology
Biological Markers
Pulmonary Embolism
Cardiology and Cardiovascular Medicine
business
Fatty Acid Binding Protein 3
Biomarkers
Subjects
Details
- Language :
- English
- ISSN :
- 07351097
- Issue :
- 19
- Database :
- OpenAIRE
- Journal :
- Journal of the American College of Cardiology
- Accession number :
- edsair.doi.dedup.....ec7b8183c032a91cf2ca86b3137d3570
- Full Text :
- https://doi.org/10.1016/j.jacc.2009.10.078