Heart-Type Fatty Acid-Binding Protein for Risk Assessment of Chronic Thromboembolic Pulmonary Hypertension

¹ Dept of Cardiology and Pulmonology, University of Goettingen, Germany
² Dept of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
³ Dept of Medical Biometry and Statistics, University Hospital of Freiburg, Germany

^* To whom correspondence should be addressed. E-mail: skonstan{at}med.uni-goettingen.de.

	Abstract

Heart-type fatty acid-binding protein (H-FABP) is a reliable marker of myocardial injury and was recently identified as a predictor of outcome in acute pulmonary embolism. We investigated the prognostic value of H-FABP in chronic thromboembolic pulmonary hypertension (CTEPH).

We studied 93 consecutive patients with CTEPH. During long-term follow-up (median duration, 1260 days; 25^th to 75^th percentile, 708–2460 days), 46 patients (49%) had an adverse outcome defined as CTEPH-related death, lung transplantation, or persistent pulmonary hypertension after pulmonary endarterectomy (PEA).

Baseline H-FABP levels in plasma ranged from 0.69 to 24.3 ng·ml^-1 (median, 3.41; 25^th to 75^th percentile, 2.28 to 4.86 ng·ml^-1). Cox regression analysis revealed a hazard ratio of 1.10 (95% CI, 1.04 to 1.18) for each increase of H-FABP by 1 ng·ml^-1 (p=0.002), and continuous elevations of H-FABP emerged as an independent predictor of adverse outcome by multivariable analysis (p=0.015). PEA was performed in 52 patients and favourably affected long-term outcome (p=0.002 by log-rank). Kaplan-Meier analysis revealed that patients with baseline H-FABP concentrations above 2.7 ng·ml^-1, the median value of the biomarker in the surgically treated population, had a lower probability of event-free survival after PEA (p=0.002).

H-FABP is a promising novel biomarker for risk stratification of patients with CTEPH.

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