Hoffmann, R. A wiki for the life sciences where authorship matters. Nature Genetics (2008)

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Puls, M. et al.

Heart-type fatty acid-binding protein permits early risk stratification of pulmonary embolism.

AIMS: We investigated the value of a novel early biomarker, heart-type fatty acid-binding protein (H-FABP), in risk stratification of patients with acute pulmonary embolism (PE). METHODS AND RESULTS: We prospectively included 107 consecutive patients with confirmed PE. The endpoints were (i) PE-related death or major complications and (ii) overall 30-day mortality. Overall, 29 patients (27%) had abnormal (>6 ng/mL) H-FABP levels at presentation. Of those, 12 (41%) had a complicated course, whereas all patients with normal baseline H-FABP had a favourable 30-day outcome (OR, 71.45; P < 0.0001). At multivariable analysis, H-FABP (P < 0.0001), but not cardiac troponin T (P = 0.13) or N-terminal pro-brain natriuretic peptide (P = 0.36), predicted an adverse outcome. Evaluation of a strategy combining biomarker testing with echocardiography revealed that patients with a negative H-FABP test had an excellent prognosis regardless of echocardiographic findings. In contrast, patients with a positive H-FABP test had a complication rate of 23.1% even in the presence of a normal echocardiogram, and this rose to 57.1% if echocardiography also demonstrated right ventricular dysfunction (OR vs. a negative H-FABP test, 5.6 and 81.4, respectively). CONCLUSION: H-FABP is a promising early indicator of right ventricular injury and dysfunction in acute PE. It may help optimize risk stratification algorithms and treatment strategies.[1]

References

Heart-type fatty acid-binding protein permits early risk stratification of pulmonary embolism. Puls, M., Dellas, C., Lankeit, M., Olschewski, M., Binder, L., Geibel, A., Reiner, C., Schäfer, K., Hasenfuss, G., Konstantinides, S. Eur. Heart J. (2007) [Pubmed]

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