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Heart-type fatty acid binding protein as a part of prognostic model of lethal results after myocardial infarction

Session Poster session 2 Sunday 08:30 - 18:00

Speaker Associate Professor Irina Vishnevskaya

Event : Heart Failure 2015

  • Topic : heart failure
  • Sub-topic : Acute Heart Failure - Other
  • Session type : Poster Session

Authors : Y Giliova (Kharkiv,UA), N Tytarenko (Kharkiv,UA), M Kopytsya (Kharkiv,UA), O Petyunina (Kharkiv,UA), O Oparin (Kharkiv,UA), I Vyshnevskaya (Kharkiv,UA), L Peteneva (Kharkiv,UA)

Authors:
Y Giliova1 , N Tytarenko1 , M Kopytsya1 , O Petyunina1 , O Oparin1 , I Vyshnevskaya1 , L Peteneva1 , 1National Institute of Therapy n.a. L.T.Malaya of NAMS of Ukraine, Cardiology Department - Kharkiv - Ukraine ,

Citation:
European Journal of Heart Failure Abstracts Supplement ( 2015 ) 17 ( Supplement 1 ), 158

Background: Heart-type Fatty Acid Binding Protein (H-FABP) is cytoplasmial protein. It releases in 30 minutes after onset of ischemia and enhances transport of fatty acids from cardiomyocites.

Aim: to examinate the prognostic value of biochemical and clinical markers and their sum in relation to development of lethal result in six months after AMI. Methods and rezults. 189 patients with AMI were examined. They were divided in two groups:1 - NSTEMI n = 36 (9%); 2 - STEMI n = 153 (81%), male 138 (73%). H-FABP was defined in blood plasma with ELISA, it's concentration was measured using normal definitions till 1 ng/ml. During 6 months of follow-up 17 patients (9%) died. About 60 clinical biochemical markers were analyzed using sequental Wald-Genkin's procedure. Following factors in died patients and survivors had significant differences: H-FABP, class of heart failure (Killip), age, glucose level. The curves of sensitivity and specificity were made using method of ROC-analysis and the threshold values were chosen for each parameter. H-FABP had sufficient level of sensitivity 85.7%, but insufficient specificity (49,2%), and such markers as age, heart failure class (Killip) and glucose level had insufficience sensitivity (50,0%; 66,7%; 43,7%) according to prognosis of lethal case. Every parameter was graded in points in relation to the cut-off value and the scale for measurement of prognostic coefficient (PC) using Gubler's method was proposed. Positive value of PC is associated with lethal result in patients with AMI.

Conclusions: The mathematical model including the sum of markers - H-FABP level, age, glucose level, heart failure class (Killip) allows to prognose lethal result in patients with AMI with sensitivity 88% and specificity 78%.

Marker

Se

Sp

AUC

p (AUC)

OR (±95% CI)

H-FABP

85,7

49,2

0,70

0,001

5,8 (1,2-19,7)

Glucose

66,7

66,7

0,68

0,033

4.0 (1,3-11,2)

Age

50,0

93,0

0,76

<0,0001

13.5 (4,3-39,1)

HF, Killip

43,7

90,8

0,70

0,066

7.7 (2,5-22,8)

Prognostic model

88,2

77,9

0,90

<0,0001

26.5 (5.4-86.4)

Se - sensitivity, Sp - specificity, AUC - area under ROC curve, P (AUC) - level of difference between AUC and 0,5, OR (±95% CI) - odds ratio with lower and upper limit 95% of confidence

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