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Heart-type fatty acid binding protein as a prognostic factor in patients with exacerbated chronic obstructive
Masamichi Sato1, Sumito Inoue1, Akira Igarashi1
1Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan.
Insights
Heart-type fatty acid binding protein (h-FABP) can predict outcomes in chronic obstructive pulmonary disease (COPD) exacerbations. Higher h-FABP levels indicate a poorer prognosis, with a cutoff of 4.5ng/ml for predicting lack of improvement.
Area of Science:
- Cardiology
- Pulmonology
- Biomarker Research
Background:
- Chronic obstructive pulmonary disease (COPD) exacerbations may involve cardiomyocyte injury, as suggested by cardiac biomarkers.
- Heart-type fatty acid binding protein (h-FABP) is a known marker for cardiomyocyte injury and heart failure prognosis.
- The prognostic value of h-FABP in COPD exacerbations is not well-established.
Purpose of the Study:
- To investigate the prognostic significance of h-FABP in patients experiencing COPD exacerbations.
- To determine if h-FABP levels can predict clinical outcomes following COPD exacerbation.
Main Methods:
- Sixty-six patients with COPD exacerbation were categorized into improved and unimproved groups based on recovery and treatment needs.
- Serum levels of h-FABP and other clinical parameters were measured at admission.
- Multivariate and receiver operating characteristic (ROC) curve analyses were performed to assess h-FABP's predictive value.
Main Results:
- The unimproved group exhibited significantly higher white blood cell counts, liver enzymes, kidney function markers, potassium, and h-FABP levels compared to the improved group.
- Lower total protein, total cholesterol, and estimated glomerular filtration rates were observed in the unimproved group.
- Higher serum h-FABP and potassium levels were independently associated with poor prognosis, with an ROC cutoff of 4.5 ng/ml for predicting lack of improvement.
Conclusions:
- Serum h-FABP levels can serve as an independent predictor of outcomes in patients with COPD exacerbation.
- h-FABP may be a valuable prognostic biomarker for assessing the severity and predicting the course of COPD exacerbations.
Background:
The designation of some cardiac-specific proteins as prognostic biomarkers in chronic obstructive pulmonary disease (COPD) exacerbations suggest that the process of exacerbation involves cardiomyocyte injury. Among these cardiac biomarkers, heart-type fatty acid binding protein (h-FABP) is considered a very sensitive diagnostic marker for cardiomyocyte injury and a prognostic marker in chronic heart failure. However, the prognostic usefulness of h-FABP in patients with COPD remains unclear.
Methods:
Sixty-six patients were enrolled in this study. Subjects who recovered from COPD exacerbation and were discharged without needing home oxygen therapy were defined as the improved group. Those who died of the COPD exacerbations, were discharged but needed home oxygen therapy, or were transferred to a rehabilitation hospital for respiratory failure and the remaining aftereffects of exacerbation were defined as the unimproved group.
Results:
The improved and unimproved groups included 54 and 12 subjects, respectively. Compared with the improved group, the unimproved group had significantly higher white blood cell counts and alanine aminotransferase, lactate dehydrogenase, blood urea nitrogen (BUN), uric acid, potassium, and h-FABP levels, and significantly lower total protein and total cholesterol levels and estimated glomerular filtration rates, either at admission or during the early morning within 24h after admission. A multivariate analysis revealed that higher serum h-FABP and potassium levels were independently predictive of a poor prognosis following a COPD exacerbation, and a receiver operating characteristic curve analysis yielded a cutoff of 4.5ng/ml for predicting lack of improvement.
Conclusion:
H-FABP may predict the outcomes of COPD exacerbation.
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