Heart-Type Fatty Acid Binding Protein, Cardiovascular Outcomes, and Death: Findings From the German CKD Cohort Study

医学 心脏型脂肪酸结合蛋白 内科学 德国的 心脏病学 队列研究 队列 脂肪酸结合蛋白 内分泌学 生物化学 考古 历史 化学 基因
作者
Markus P. Schneider,Matthias Schmid,Jennifer Nadal,Christoph Wanner,Vera Krane,Jürgen Floege,Turgay Saritas,Martin Busch,Thomas Sitter,Nele Friedrich,Helena Stockmann,Heike Meiselbach,Matthias Nauck,Florian Kronenberg,Kai‐Uwe Eckardt,Mario Schiffer,Hans‐Ulrich Prokosch,Barbara Bärthlein,Andreas Beck,André Reis,Arif B. Ekici,Susanne Becker,Dinah Becker-Grosspitsch,Matthias Schmid,Birgit Hausknecht,Anke Weigel,Gerd Walz,Anna Köttgen,Ulla T. Schultheiß,Fruzsina Kotsis,Simone Meder,Erna Mitsch,Ursula Reinhard,Elke Schaeffner,Seema Baid‐Agrawal,Kerstin Theisen,Hermann Haller,Jan Menne,Martin Zeier,Claudia Sommerer,Johanna Theilinger,G Wolf,Rainer Paul,Antje Börner-Klein,Britta Bauer,Julia Raschenberger,Barbara Kollerits,Lukas Forer,Sebastian Schönherr,Hansi Weißensteiner,Peter J. Oefner,Wolfram Gronwald
出处
期刊:American Journal of Kidney Diseases [Elsevier BV]
卷期号:80 (4): 483-494.e1 被引量:1
标识
DOI:10.1053/j.ajkd.2022.01.424
摘要

Rationale & Objective Heart-type fatty acid binding protein (H-FABP) is a biomarker that has been shown to provide long-term prognostic information in patients with coronary artery disease independently of high-sensitivity troponin T (hs-TNT). We examined the independent associations of H-FABP with cardiovascular outcomes in patients with chronic kidney disease (CKD). Study Design Prospective cohort study. Setting & Participants 4,951 patients enrolled in the German Chronic Kidney Disease (GCKD) study with an estimated glomerular filtration rate of 30-60 mL/min/1.73 m2 or overt proteinuria (urinary albumin-creatinine ratio > 300 mg/g or equivalent). Exposure Serum levels of H-FABP and hs-TNT were measured at study entry. Outcome Noncardiovascular (non-CV) death, CV death, combined major adverse CV events (MACE), and hospitalization for congestive heart failure (CHF). Analytical Approach Hazard ratios (HRs) for associations of H-FABP and hs-TNT with outcomes were estimated using Cox regression analyses adjusted for established risk factors. Results During a maximum follow-up of 6.5 years, 579 non-CV deaths, 190 CV deaths, 522 MACE, and 381 CHF hospitalizations were observed. In Cox regression analyses adjusted for established risk factors, H-FABP was associated with all 4 outcomes, albeit with lower HRs than those found for hs-TNT. After further adjustment for hs-TNT levels, H-FABP was found to be associated with non-CV death (HR, 1.57 [95% CI, 1.14-2.18]) and MACE (HR, 1.40 [95% CI, 1.02-1.92]) but with neither CV death (HR, 1.64 [95% CI, 0.90-2.99]) nor CHF hospitalizations (HR, 1.02 [95% CI, 0.70-1.49]). Limitations Single-point measurements of H-FABP and hs-TNT. Uncertain generalizability to non-European populations. Conclusions In this large cohort of patients with CKD, H-FABP was associated with non-CV death and MACE, even after adjustment for hs-TNT. Whether measurement of H-FABP improves cardiovascular disease risk prediction in these patients warrants further studies. Heart-type fatty acid binding protein (H-FABP) is a biomarker that has been shown to provide long-term prognostic information in patients with coronary artery disease independently of high-sensitivity troponin T (hs-TNT). We examined the independent associations of H-FABP with cardiovascular outcomes in patients with chronic kidney disease (CKD). Prospective cohort study. 4,951 patients enrolled in the German Chronic Kidney Disease (GCKD) study with an estimated glomerular filtration rate of 30-60 mL/min/1.73 m2 or overt proteinuria (urinary albumin-creatinine ratio > 300 mg/g or equivalent). Serum levels of H-FABP and hs-TNT were measured at study entry. Noncardiovascular (non-CV) death, CV death, combined major adverse CV events (MACE), and hospitalization for congestive heart failure (CHF). Hazard ratios (HRs) for associations of H-FABP and hs-TNT with outcomes were estimated using Cox regression analyses adjusted for established risk factors. During a maximum follow-up of 6.5 years, 579 non-CV deaths, 190 CV deaths, 522 MACE, and 381 CHF hospitalizations were observed. In Cox regression analyses adjusted for established risk factors, H-FABP was associated with all 4 outcomes, albeit with lower HRs than those found for hs-TNT. After further adjustment for hs-TNT levels, H-FABP was found to be associated with non-CV death (HR, 1.57 [95% CI, 1.14-2.18]) and MACE (HR, 1.40 [95% CI, 1.02-1.92]) but with neither CV death (HR, 1.64 [95% CI, 0.90-2.99]) nor CHF hospitalizations (HR, 1.02 [95% CI, 0.70-1.49]). Single-point measurements of H-FABP and hs-TNT. Uncertain generalizability to non-European populations. In this large cohort of patients with CKD, H-FABP was associated with non-CV death and MACE, even after adjustment for hs-TNT. Whether measurement of H-FABP improves cardiovascular disease risk prediction in these patients warrants further studies.
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