Circulating heart-type fatty acid binding protein levels predict the occurrence of appropriate shocks and cardiac death in patients with implantable cardioverter-defibrillators.

Abstract

BACKGROUND:

The association between ongoing myocardial damage and outcomes in patients who have received an implantable cardioverter-defibrillator (ICD) is unclear.

METHODS AND RESULTS:

Consecutive patients with cardiomyopathy, who had received an ICD (n = 107, mean age 65 ± 11 years), were prospectively enrolled. Myocardial membrane injury (heart-type fatty acid binding protein [H-FABP] >4.3 ng/mL) and myofibrillar injury (troponin T >0.01 ng/mL) were defined using receiver operating characteristic curves. Patients were followed for a median of 33.6 months, to an end point of appropriate ICD shock or cardiac death. Myocardial membrane injury (45%) and myofibrillar injury (41%) were equally prevalent among patients with cardiomyopathy who had received ICDs. Appropriate ICD shocks or cardiac death occurred in 31% and 15% of patients, respectively. Multivariate Cox regression analysis showed that serum H-FABP levels >4.3 ng/mL, but not troponin T levels, were a significant independent prognostic factor for cardiac events (hazard ratio 5.502, 95% confidence interval 1.705-17.75, P = .004). Subgroup analysis revealed that measuring H-FABP levels was valuable for anticipating event-free survival among patients with ICDs who were receiving amiodarone. High H-FABP levels also predicted subsequent outcomes in patients who had received ICDs for primary or secondary prevention.

CONCLUSION:

Evaluating myocardial damage using H-FABP may be a promising tool for predicting outcomes in patients with cardiomyopathy who have received ICDs.

• Authors: Hyuma Daidoji, Takanori Arimoto, Joji Nitobe, Harutoshi Tamura, Daisuke Kutsuzawa, Daisuke Ishigaki, Mitsunori Ishino, Hiroki Takahashi, Tetsuro Shishido, Takehiko Miyashita, Takuya Miyamoto, Tetsu Watanabe, Isao Kubota
• Journal: Journal of cardiac failure (J Card Fail) Vol. 18 Issue 7 Pg. 556-63 (Jul 2012) ISSN: 1532-8414 [Electronic] United States
• PMID: 22748489 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Chemical References

• Anti-Arrhythmia Agents
• FABP3 protein, human
• Fatty Acid Binding Protein 3
• Fatty Acid-Binding Proteins
• Troponin T
• Natriuretic Peptide, Brain
• Amiodarone

Topics

• Adult
• Aged
• Aged, 80 and over
• Amiodarone (therapeutic use)
• Anti-Arrhythmia Agents (therapeutic use)
• Atrial Fibrillation (prevention & control)
• Cardiomyopathies (blood, mortality)
• Death, Sudden, Cardiac (prevention & control)
• Defibrillators, Implantable
• Echocardiography
• Fatty Acid Binding Protein 3
• Fatty Acid-Binding Proteins (blood)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Multivariate Analysis
• Natriuretic Peptide, Brain (blood)
• Prognosis
• Prospective Studies
• Troponin T (blood)