Serum Heart-Type Fatty Acid-Binding Protein Level Can Be Used to Detect Acute Kidney Injury on Admission and Predict an Adverse Outcome in Patients With Acute Heart Failure

Akihiro Shirakabe; Noritake Hata; Nobuaki Kobayashi; Hirotake Okazaki; Takuro Shinada; Kazunori Tomita; Masanori Yamamoto; Masafumi Tsurumi; Masato Matsushita; Yoshiya Yamamoto; Shinya Yokoyama; Kuniya Asai; Wataru Shimizu

doi:10.1253/circj.CJ-14-0653

Heart Failure

Serum Heart-Type Fatty Acid-Binding Protein Level Can Be Used to Detect Acute Kidney Injury on Admission and Predict an Adverse Outcome in Patients With Acute Heart Failure

Akihiro Shirakabe, Noritake Hata, Nobuaki Kobayashi, Hirotake Okazaki, Takuro Shinada, Kazunori Tomita, Masanori Yamamoto, Masafumi Tsurumi, Masato Matsushita, Yoshiya Yamamoto, Shinya Yokoyama, Kuniya Asai, Wataru Shimizu

Author information

Akihiro Shirakabe
Division of Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School
Noritake Hata
Division of Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School
Nobuaki Kobayashi
Division of Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School
Hirotake Okazaki
Division of Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School
Takuro Shinada
Division of Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School
Kazunori Tomita
Division of Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School
Masanori Yamamoto
Division of Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School
Masafumi Tsurumi
Division of Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School
Masato Matsushita
Division of Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School
Yoshiya Yamamoto
Division of Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School
Shinya Yokoyama
Division of Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School
Kuniya Asai
Department of Cardiovascular Medicine, Nippon Medical School
Wataru Shimizu
Department of Cardiovascular Medicine, Nippon Medical School

Keywords: Acute decompensated heart failure, Liver fatty acid-binding protein, Mortality, Neutrophil gelatinase-associated lipocalin, Renal function

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2014 Volume 79 Issue 1 Pages 119-128

DOI https://doi.org/10.1253/circj.CJ-14-0653

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Abstract

Background:Different mechanisms of acute kidney injury (AKI) may exist for acute heart failure (AHF) patients compared with other patients.Methods and Results:We analyzed data from 282 patients with AHF. The biomarkers were measured within 30 min of admission. Patients were assigned to a no-AKI (n=213) or AKI group (Class R (n=49), Class I (n=15) or Class F (n=5)) using the RIFLE classifications on admission. We evaluated the relationships between the biomarkers and AKI, in-hospital mortality, all-cause death and HF events (HF re-admission, all-cause death) within 90 days. The serum heart-type fatty acid-binding protein (s-HFABP) levels were significantly higher in the AKI than in the no-AKI group, and the predictive biomarker for AKI was s-HFABP (odds ratio: 6.709; 95% confidence interval: 3.362–13.391). s-HFABP demonstrated an optimal balance between sensitivity and specificity (71.0%, 79.3%; area under the receiver-operating characteristic curve [AUC]=0.790) at 22.8 ng/ml for AKI, at 22.8 ng/ml for Class I/F (90.0%, 71.4%; AUC=0.836) and at 21.0 ng/ml for in-hospital mortality (74.3%, 70.0%; AUC=0.726). The Kaplan-Meier survival curves showed a significantly poorer prognosis in the high s-HFABP group (≥22.9 ng/ml) than in other groups.Conclusions:The s-HFABP level can indicate AKI on admission, and a high s-HFABP level is associated with a poorer prognosis for AHF patients. (Circ J 2015; 79: 119–128)

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