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Effects of joint detection of heart-type fatty acid binding protein and brain natriuretic peptide on prognosis and risk stratification in patients with chronic heart failure

Objective To investigate the prognostic factors affecting chronic heart failure(CHF) and risk stratification through joint detection of heart-type fatty acid binding protein(H-FABP) and brain natriuretic peptide(BNP) and follow-up study in CHF patients. Methods CHF patients(n=184, male 109, female 75, aged from 25 to 92 and average age=67±12) were chosen from Jan. 2009 to Dec. 2012, and then divided, according to whether or not having major adverse cardiovascular events(MACE), into non-MACE group(n=141) and MACE group(n=43). The levels of H-FABP and BNP were detected at admission time, and incidence of MACE was followed up after discharge for 6 m. The cut-off values of H-FABP and BNP were determined by using receiver operating characteristic curve(ROC), and then according to these cut-off values, the patients were given risk stratification and divided into normal group(n=67), low-risk group 1(n=30), low-risk group 2(n=33) and high-risk group(n=54). Results Age increased, percentage of cases of NYHA grade IV increased and levels of BNP and H-FABP were higher in MACE group compared with non-MACE group(all P0.05). When the cut-off value of H-FABP was 4.3 ng/m L, the specificity was 62.1% and sensitivity was 84.0%. When the cut-off value of BNP was 200 pg/m L, the specificity was 61.9% and sensitivity was 70.2%. H-FABP4.3 ng/m L(RR=5.415, 95%CI: 2.201~13.324) and BNP200 pg/m L(RR=2.412, 95%CI: 1.016~5.731) were risk factors of MACE. There were 4 cases(6.0%) with MACE in normal group, 3(10.0%) in low-risk group 1, 8(24.2%) in low-risk group 2 and 28(51.9%) in high-risk group. The incidence of MACE increased in high-risk group compared with normal group(P0.01). Conclusion The joint detection of H-FABP and BNP is a reliable index for determining prognosis and risk stratification in CHF patients.