Prognostic relevance of plasma heart-type fatty acid binding protein after out-of-hospital cardiac arrest

Abstract

Objective: Heart-type fatty acid binding protein (H-FABP) is a tissue-specific protein which is rapidly released into the circulation when cardiomyocyte injury occurs. The aim of the study is to investigate the prognostic relevance of H-FABP for out-of-hospital cardiac arrest (OHCA) patients in the early post-cardiac arrest period.

Design and methods: This is a prospective cohort study enrolling non-traumatic resuscitated OHCA patients.

Results: A total of 106 patients were enrolled. The H-FABP level at 24h was correlated to the duration from collapse to return of spontaneous circulation (p<0.001, R(2)=0.549). The outcomes of survival to discharge were worse in the patient group with the higher tertile of plasma H-FABP level at 24h after the event (p=0.011). Multivariate analysis demonstrated that the significant predictors for in-hospital mortality were APACHE II score (p=0.010), gender (p=0.025) and the tertiles of H-FABP at 24h with hazard ratios for the lowest, middle, and highest tertiles being 1.0, 1.157 (95% confidence interval 0.435-3.075, p=0.770), and 2.840 (95% confidence interval 1.137-7.092, p=0.025), respectively.

Conclusion: The plasma level of H-FABP at 24h after the event may be an early and independent factor associated with survival to discharge in OHCA patients.

Keywords: Heart-type fatty acid binding protein; Out-of-hospital cardiac arrest; Outcome; Prognosis; Troponin I.