Combination of heart-type fatty acid binding protein and brain natriuretic peptide can reliably risk stratify patients hospitalized for chronic heart failure
Combination of heart-type fatty acid binding protein and brain natriuretic peptide can reliably risk stratify patients hospitalized for chronic heart failure
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DOI：
10.1253/circj.69.922
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发表时间：
2005-08-01
影响因子：
3.3
通讯作者：
Kubota, I
中科院分区：
文献类型：
--
作者：
Niizeki, T;Takeishi, Y;Kubota, I
背景本研究的目的是前瞻性研究入院时心肌细胞损伤和左心室超负荷标志物的组合是否可以可靠地对因慢性心力衰竭（CHF）住院的患者进行风险分层。方法和结果血清心脏型脂肪酸结合蛋白（H-FABP）浓度和血浆脑钠肽（BNP）浓度在平均534 ± 350天的随访期内，有44例心脏事件，包括16例心脏性死亡和28例因心力衰竭恶化而再次入院。根据受试者工作特征曲线确定H-FABP和BNP值的正常上限（H-FABP为4.3 ng/ml，BNP为200 pg/ml）。逐步考克斯回归分析表明，高H-FABP（风险比5.416，p=0.0002）和高BNP（风险比2.411，p=0.0463）是心脏事件的独立预测因子。入院时高浓度的H-FABP和BNP与心脏死亡率和心脏事件的发生率最高相关。Kaplan-Meier分析也表明，H-FABP和BNP浓度相结合，可以可靠地分层患者的心脏events. ConclusionCombined测量H-FABP和BNP浓度在入院时可能是一个高度可靠的评估为CHF住院患者的风险分层。
Background The aim of the present study was to prospectively study whether a combination of markers for myocardial cell injury and left ventricular overload at admission can reliably risk stratify patients hospitalized for chronic heart failure (CHF).Methods and Results Serum concentrations of heart-type fatty acid binding protein (H-FABP) and plasma concentrations of brain natriuretic peptide (BNP) were measured at admission in 186 consecutive patients hospitalized for CHR During a mean follow-up period of 534 +/- 350 days, there were 44 cardiac events, including 16 cardiac deaths and 28 readmissions for worsening heart failure. Normal upper limits for H-FABP and BNP values were determined from the receiver operating characteristic curves (4.3 ng/ml for H-FABP and 200 pg/ml for BNP). A stepwise Cox regression analysis demonstrated that high H-FABP (hazard ratio 5.416, p=0.0002) and high BNP (hazard ratio 2.411, p=0.0463) were independent predictors of cardiac events. High concentrations of both H-FABP and BNP at admission were associated with the highest incidence of cardiac mortality and cardiac events. Kaplan-Meier analysis also showed that the combination of H-FABP and BNP concentrations could reliably stratify patients for cardiac events.Conclusion Combined measurement of H-FABP and BNP concentrations at admission may be a highly reliable evaluation for risk stratifying patients hospitalized for CHF.