[Heart-type fatty acid binding protein for the assessment of the short-term prognosis in acute pulmonary embolism patients with hemodynamic stability on admission].

OBJECTIVE

To explore the clinical value of heart-type fatty acid binding protein (H-FABP) for the assessment of the short-term prognosis in acute pulmonary embolism (APE) patients with hemodynamic stability on admission.

METHOD

A total of 156 APE patients with hemodynamic stability on admission were hospitalized in Beijing Anzhen hospital from December 2009 to December 2010, and the final study population comprised 90 patients [37 men and 53 women; age (61.1 ± 14.6) years], who were taken blood samples before thrombolysis or anticoagulation for plasma H-FABP level measurement by a solid-phase enzyme-linked immunoabsorbent assay based on the sandwich principle, cardiac troponin I (cTnI) and N-terminal pro-brain natriuretic peptide (NT-proBNP) by heterogeneous immunoassay. All had 30-day follow-up and divided them into the complicated clinical course group (n = 7) and the simple clinical course group (n = 83). The clinical and follow-up data was analyzed by Mann-Whitney U test, Pearson Chi-Square test, Continuity Correction test and logistic regression.

RESULTS

The level of H-FABP was higher in the complicated clinical course group than it in the simple clinical course group (U = 54.000, P < 0.01). With ROC analysis, 7 µg/L was identified as the best cutoff value of H-FABP in this study, and the differences of AUC among H-FABP, cTnI and NT-proBNP were no statistical significance. By univariable logistic regression, H-FABP ≥ 6 µg/L, heart rate ≥ 106 beats/min and syncope ( all P < 0.01) may predict the short-term prognosis in APE patients with hemodynamic stability. H-FABP ≥ 6 µg/L and syncope (both P < 0.05) may also be 30-day predictor by multivariable logistic regression. NT-proBNP or cTnI combined with H-FABP may increase 30-day prognosis value in APE patients with hemodynamic stability.

CONCLUSIONS

H-FABP, alone or in combination with other clinical data may predict 30-day prognosis in APE patients with hemodynamic stability on admission. H-FABP is superior to cTnI and NT-proBNP in the predication of 30-day prognosis in APE patients with hemodynamic stability on admission.