TY  - JOUR
SN  - 1471-2261
TI  - Ischemic biomarker heart-type fatty acid binding protein (hFABP) in acute heart failure - diagnostic and prognostic insights compared to NT-proBNP and troponin I
Y1  - 2015///
SP  - 1
A1  - Hoffmann, Ursula
A1  - Espeter, Florian
A1  - Weiß, Christel
A1  - Ahmad-Nejad, Parviz
A1  - Lang, Siegfried
A1  - Brückmann, Martina
A1  - Akin, Ibrahim
A1  - Neumaier, Michael
A1  - Borggrefe, Martin
A1  - Behnes, Michael
EP  - 12
CY  - London
JF  - BMC Cardiovascular Disorders
N2  - Background: To 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).   Methods: 401 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.   Results: Additional 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.   Conclusions: Combining 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 registration: ClinicalTrials.gov identifier: NCT00143793  .  
UR  - https://archiv.ub.uni-heidelberg.de/volltextserver/19376/
IS  - 50
AV  - public
PB  - BioMed Central
ID  - heidok19376
VL  - 15
ER  -