Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
ORIGINAL ARTICLES
Prognostic Value of Myocardial Damage Markers in Patients with Chronic Heart Failure with Atrial Fibrillation
Yoichiro Otaki, Takanori Arimoto, Hiroki Takahashi, Shinpei Kadowaki, Daisuke Ishigaki, Taro Narumi, Yuki Honda, Tadateru Iwayama, Satoshi Nishiyama, Tetsuro Shishido, Takehiko Miyashita, Takuya Miyamoto, Tetsu Watanabe, Isao Kubota
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Keywords: atrial fibrillation, heart type fatty acid binding protein, troponin T
JOURNAL OPEN ACCESS

2014 Volume 53 Issue 7 Pages 661-668

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Abstract

Objective The aim of the present study was to examine the relationship between myocardial damage caused by atrial fibrillation (AF) and subsequent cardiovascular events in AF patients with chronic heart failure (CHF).
Methods and Results We measured the serum levels of heart-type fatty acid binding protein (H-FABP) and high-sensitivity troponin T in 402 consecutive CHF patients with chronic AF (CHF-AF, n=201) or sinus rhythm (CHF-SR, n=201). The patients with CHF-AF had higher H-FABP and troponin T levels than those with CHF-SR. In order to examine the prognostic value of myocardial damage markers in CHF-AF and CHF-SR patients, we followed the above patients and analyzed their clinical outcomes. A multivariate Cox proportional hazard analysis revealed that both the serum H-FABP and troponin T levels independently predicted subsequent cardiovascular events. A Kaplan-Meier analysis demonstrated that the rate of cardiovascular events was higher in the patients with elevated H-FABP and troponin T levels. The optimal cut-off values for the myocardial damage markers of cardiovascular events were higher in the CHF-AF patients than in the CHF-SR patients (H-FABP, 5.4 vs. 4.6 ng/mL and troponin T, 0.030 vs. 0.013 ng/mL).
Conclusion Myocardial damage advances in association with the presence of AF and is associated with subsequent cardiovascular events in both CHF-AF and CHF-SR patients. In this study, the cut-off values for the myocardial damage markers were higher in the CHF-AF patients than in the CHF-SR patients.

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© 2014 by The Japanese Society of Internal Medicine
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