Clinical value of heart type fatty acid binding protein (H-FABP) in acute pulmonary thromboembolism

Year 2022, Volume: 5 Issue: 3, 861 - 867, 30.05.2022

Tuba Altuğ Ayşegül Şentürk Murat Alışık Cemile Biçer

https://doi.org/10.32322/jhsm.1093848

Abstract

Introduction: To investigate factors which could possibly be prognostic, to decide on thrombolytic therapy as soon as possible, and to determine the prognostic value of H-FABP, which is a new marker, in pulmonary thromboembolism.
Material and Method: In our study, a patient group, consisting of 58 patients diagnosed with PTE and a control group of 30 healthy individuals were investigated. According to their risk of mortality, patients were analyzed in three groups: high, moderate and low. The moderate mortality risk groups were categorized into two groups according to PAP and patients with PAP≥45 mmHg were “Group 1” and PAP<45 mmHg were “Group 2”. Differences in levels of H-FABP and other cardiac prognostic markers between these groups were analyzed.
Results: H-FABP level was measured as 507.6±99.3 pg/ml in the control group and 3203.1±2389.3 pg/ml in the patient group. H-FABP level was found to be the highest in the high mortality risk group, and the lowest in the low mortality risk group (p<0.001). Moreover, in the subgroups of moderate mortality risk group, H-FABP levels were significantly higher in group 1 compared to group 2. For the evaluation of other cardiac markers in PTE subgroups, pro-BNP level was the highest in the high mortality risk group, and the lowest in the low mortality risk group.
Conclusion: The findings in this study show that, H-FABP is a superior marker in determining the prognosis compared to pro-BNP and troponin. High PAP level is one of the important prognostic markers that should be considered along with the electrocardiography findings.

Keywords

Pulmonary thromboembolism, H-FABP, Cardiac enzymes, Prognostic factors, Thrombolytic treatment

References

• Dalen JE. Pulmonary embolism: what have we learned since Virchow? Natural history, pathophysiology, and diagnosis. Chest 2002; 122: 1440-56.
• Nijkeuter M, Sohne M, Tick LW, et al. The natural course of hemodynamically stable pulmonary embolism: clinical outcome and risk factors in a large prospective cohort study. Chest 2007; 131: 517-23.
• Duffett L, Castellucci L A, Forgie M A. Pulmonary embolism: update on management and controversies BMJ 2020; 370.
• Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J 2020; 41: 543-603.
• Babaoglu E, Hasanoglu HC, Senturk A, et al. Importance of biomarkers in risk stratification of pulmonary thromboembolism patients. J Investig Med 2014; 62: 328-31.
• Puls M, Dellas C, Lankeit M, et al. Heart-type fatty acid-binding protein permits early risk stratification of pulmonary embolism. Eur Heart J 2007; 28: 224-9.
• Moorjani N, Price S. Massive pulmonary embolism. Cardiology Clinics 2013; 31: 503-18.
• Otaki Y, Watanabe T, Kubota I. Heart-type fatty acid-binding protein in cardiovascular disease: a systemic review. Clin Chim Acta 2017; 474: 44-3.
• Qian HY, Huang J, Yang YJ, et al. Heart-type fatty acid binding protein in the assessment of acute pulmonary embolism. Am J Med Sci 2016; 352: 557-62.
• Marti C, John G, Konstantinides S, et al. Systemic thrombolytic therapy for acute pulmonary embolism: a systematic review and meta-analysis. Eur Heart J 2015; 36: 605–14.
• Konstantinides SV, Meyer G, Becattini C 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J 2020; 41: 543-603.
• Vuilleumier N, Righini M, Perrier A, et al. Correlation between cardiac biomarkers and right ventricular enlargement on chest CT in non massive pulmonary embolism. Thrombosis Research 2008; 121: 617-24.
• Cavallazzi R, Nair A, Vasu T, et al. Natriuretic peptides in acute pulmonary embolism: a systematic review. Intensive Care Med 2008; 34: 2147.
• Kostrubiec M, Pruszczyk P, Bochowicz A, et al. Biomarker-based risk assessmen7t model in acute pulmonary embolism. Eur Heart J 2005; 26: 2166-72.
• Pruszczyk P, Bochowicz A, Torbicki A, et al. Cardiac troponin T monitoring identifies high-risk group of normotensive patients with acute pulmonary embolism. Chest 2003; 123: 1947-52.
• Golpe R, Pérez-de-Llano LA, Castro-Añón O, et al. [Troponin-I in hemodynamically-stable pulmonary embolism: correlation with echocardiography and computed tomography angiography]. Rev Clin Esp 2011; 211: 69-75.
• Sanchez O, Trinquart L, Colombet I, et al. Prognostic value of right ventricular dysfunction in patients with haemodynamically stable pulmonary embolism: a systematic review. Eur Heart J 2008; 29: 1569-77.
• Dellas C, Puls M, Lankeit M, et al. Elevated heart-type fatty acid-binding protein levels on admission predict an adverse outcome in normotensive patients with acute pulmonary embolism. J Am Coll Cardiol 2010; 55: 2150-7.
• Langer M, Forkmann M, Richter U, et al. Heart-type fatty acid-binding protein and myocardial creatine kinase enable rapid risk stratification in normotensive patients with pulmonary embolism. J Crit Care 2016; 35: 174-9.
• Lauque D, Maupas-Schwalm F, Bounes V, et al. Predictive value of the heart-type fatty acid-binding protein and the pulmonary embolism severity index in patients with acute pulmonary embolism in the emergency department. Acad Emerg Med 2014; 21: 1143-50.
• Jenab Y, Pourjafari M, Sotoudeh M, et al. Comparing the effect of cardiac biomarkers on the outcome of normotensive patients with acute pulmonary embolism. Monaldi Arch Chest Dis 2017; 87: 767.
• Lee AY, Levine MN. Venous thromboembolism and cancer: risks and outcomes. Circulation 2003; 107: I17-21.
• Khorana AA, Mackman N, Falanga A, et al. Cancer-associated venous thromboembolism. Nat Rev Dis Primers 2022; 8: 11.
• Senturk A, Ozsu S, Duru S, et al. Prognostic importance of central thrombus in hemodynamically stable patients with pulmonary embolism. Cardiol J 2017; 24: 508-14.