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Prognostic impact of the serum heart-type fatty acid-binding protein (H-FABP) levels in patients admitted to the non-surgical intensive care unit

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Abstract

Background

Biomarkers predicting adverse outcomes in non-surgical intensive care patients have not been reported.

Methods and results

Data for 1,006 emergency department patients were prospectively analyzed. The serum heart-type fatty acid-binding protein (s-H-FABP) level was measured within 10 min of admission. The patients were assigned to intensive care (n = 835) or other departments (n = 171). The intensive care patients were divided into survivors (n = 745) and non-survivors (n = 90) according to the in-hospital mortality and assigned to four groups according to the quartiles of s-H-FABP (Q1, Q2, Q3 and Q4). The s-H-FABP levels were significantly higher in the intensive care patients (12.7 [6.1–38.8] ng/ml versus 5.3 [3.1–9.4] ng/ml) and in the non-survivors (44.9 [23.2–87.6] ng/ml versus 11.5 [5.6–32.6] ng/ml). A Kaplan–Meier curve showed a significantly higher survival rate in Q3 than in Q1 and Q2 and in Q4 than in the other groups. The multivariate Cox regression model identified Q3 (HR 4.646, 95 % CI 1.526–14.146) and Q4 (HR 9.483, 95 % CI 3.152–28.525) as independent predictors of 90-day mortality. The sensitivity and specificity of H-FABP for in-hospital mortality were 81.1 and 66.0 % (AUC 0.775) at 20.95 ng/ml. The in-hospitality rate was significantly higher in the high s-H-FABP patients than in the low s-H-FABP patients in each etiology group.

Conclusions

The s-H-FABP level is an effective biomarker for risk stratification in non-surgical intensive care patients.

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Acknowledgments

We are grateful to the staff of the ICU and medical records office at Chiba Hokusoh Hospital, Nippon Medical School for collecting the medical data. Funding none declared.

Conflict of interest

None declared.

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Authors and Affiliations

  1. Division of Intensive Care Unit, Nippon Medical School, Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan

    Akihiro Shirakabe, Nobuaki Kobayashi, Noritake Hata, Masanori Yamamoto, Takuro Shinada, Kazunori Tomita, Masafumi Tsurumi, Masato Matsushita, Hirotake Okazaki, Yoshiya Yamamoto & Shinya Yokoyama

  2. Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan

    Kuniya Asai & Wataru Shimizu

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  1. Akihiro Shirakabe
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Correspondence to Akihiro Shirakabe.

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Shirakabe, A., Kobayashi, N., Hata, N. et al. Prognostic impact of the serum heart-type fatty acid-binding protein (H-FABP) levels in patients admitted to the non-surgical intensive care unit. Clin Res Cardiol 103, 791–804 (2014). https://doi.org/10.1007/s00392-014-0717-z

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  • DOI: https://doi.org/10.1007/s00392-014-0717-z

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