Abstract
BackgroundHeart-type fatty acid-binding protein (H-FABP) is a novel marker of myocardial injury and has been reported to be associated with cardiovascular diseases (CVD) including patients with diabetes mellitus (DM). Unfortunately, its prognostic value in patients with CVD and impaired glucose metabolism (IGM) is unclear. The objective of this study was to investigate the prognostic value of H-FABP in CVD patients with IGM.MethodsA total of 4594 patients with angiography-proven coronary artery disease (CAD) were enrolled and divided into subgroup according to glucose metabolism status (normal glucose regulation [NGR], pre-DM, and DM). Baseline levels of H-FABP were measured using latex immunoturbidimetric method. The cardiovascular events (CVE) were defined as cardiovascular death, myocardial infarction, stroke and coronary revascularization. Cox regression and Kaplan–Meier analysis were used to evaluate the relations of H-FABP and glucose metabolism status to CVEs.ResultsDuring the follow-up period with up to 7.1 years, 380 CVEs occurred. Patients with CVE had higher levels of H-FABP compared to those without CVE (p < 0.001). Interestingly, H-FABP levels were also elevated in DM and pre-DM groups compared with NGR group (p < 0.001), when combined glucose metabolism status with H-FABP stratification, patients in the highest tertile of H-FABP appeared to have higher risk of CVEs with pre-DM (adjusted hazard ratio [HR]: 1.855, 95% confidential intervals [CIs] 1.076–3.214; p = 0.033) and DM (adjusted HR: 2.560, 95% CIs 1.409–4.650; p = 0.002). The Kaplan–Meier curve indicated that DM patients with the highest H-FABP levels were associated with the greatest risk of CVEs (p < 0.05).ConclusionsOur data firstly showed that elevated H-FABP levels were associated with worse outcomes in CAD patients with pre-DM and DM, which provided the novel information that H-FABP might be a prognostic marker for clinical outcomes among patients with CAD and IGM.
Highlights
Heart-type fatty acid-binding protein (H-FABP) is a novel marker of myocardial injury and has been reported to be associated with cardiovascular diseases (CVD) including patients with diabetes mellitus (DM)
Besides the atherosclerosis of large arteries can be induced by impaired glucose metabolism (IGM), previous studies have provided the evidence supporting the relation of IGM to myocardial injury and silent ischemia among patients with IGM [12,13,14]
Data suggested that patients with higher H-FABP levels were older compared to those with lower H-FABP levels, but there was no significant difference in gender distribution with different H-FABP levels
Summary
Heart-type fatty acid-binding protein (H-FABP) is a novel marker of myocardial injury and has been reported to be associated with cardiovascular diseases (CVD) including patients with diabetes mellitus (DM). Unfortu‐ nately, its prognostic value in patients with CVD and impaired glucose metabolism (IGM) is unclear. The objective of this study was to investigate the prognostic value of H-FABP in CVD patients with IGM. It is well known that diabetes mellitus (DM) is a type of metabolic disease closely correlated with classic cardiovascular risk factors, such as obesity, hypertension, and dyslipidemia. Besides the atherosclerosis of large arteries can be induced by impaired glucose metabolism (IGM), previous studies have provided the evidence supporting the relation of IGM to myocardial injury and silent ischemia among patients with IGM [12,13,14]. Previous studies have revealed that diabetic patients might suffer from cardiac dysfunction due to its complications such as diabetic cardiomyopathy or diabetic vasculopathy [15, 16]
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