Urinary liver‐type fatty acid‐binding protein as a prognostic marker in patients with acute heart failure
Aims Urinary liver‐type fatty acid‐binding protein (L‐FABP) is expressed in proximal tubular epithelial cells and excreted into the urine during tubular injury. We hypothesized that high urinary L‐FABP is associated with poor prognosis in patients with acute heart failure (AHF). Methods and results...
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Published in | ESC Heart Failure Vol. 9; no. 1; pp. 442 - 449 |
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Main Authors | , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
England
John Wiley & Sons, Inc
01.02.2022
John Wiley and Sons Inc Wiley |
Subjects | |
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Abstract | Aims
Urinary liver‐type fatty acid‐binding protein (L‐FABP) is expressed in proximal tubular epithelial cells and excreted into the urine during tubular injury. We hypothesized that high urinary L‐FABP is associated with poor prognosis in patients with acute heart failure (AHF).
Methods and results
We analysed 623 patients (74 ± 13 years old; 60.0% male patients) with AHF. Urinary L‐FABP levels were measured at the time of admission and adjusted for the urinary creatinine concentration. The primary endpoint was all‐cause mortality. The median value and interquartile range of urinary L‐FABP levels were 6.66 and 3.37–21.1 μg/gCr, respectively. Urinary L‐FABP levels were significantly correlated with both beta‐2 microglobulin and cystatin C levels; the correlation with the former was higher than that with the latter. During the follow‐up of 631 (interquartile range: 387–875) days, 142 deaths occurred. A high tertile of urinary L‐FABP level was associated with high mortality; this association was retained after adjusting for other covariates (second tertile hazard ratio 1.40, P = 0.152 vs. first tertile; third tertile hazard ratio 1.94, P = 0.005 vs. first tertile).
Conclusions
Urinary L‐FABP is more closely associated with tubular dysfunction than with glomerular dysfunction. Tubular dysfunction, which was evaluated based on urinary L‐FABP levels, in patients with AHF is associated with all‐cause mortality and is independent of pre‐existing risk factors. L‐FABP should be considered for use in the prognosis of AHF. |
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AbstractList | Aims
Urinary liver‐type fatty acid‐binding protein (L‐FABP) is expressed in proximal tubular epithelial cells and excreted into the urine during tubular injury. We hypothesized that high urinary L‐FABP is associated with poor prognosis in patients with acute heart failure (AHF).
Methods and results
We analysed 623 patients (74 ± 13 years old; 60.0% male patients) with AHF. Urinary L‐FABP levels were measured at the time of admission and adjusted for the urinary creatinine concentration. The primary endpoint was all‐cause mortality. The median value and interquartile range of urinary L‐FABP levels were 6.66 and 3.37–21.1 μg/gCr, respectively. Urinary L‐FABP levels were significantly correlated with both beta‐2 microglobulin and cystatin C levels; the correlation with the former was higher than that with the latter. During the follow‐up of 631 (interquartile range: 387–875) days, 142 deaths occurred. A high tertile of urinary L‐FABP level was associated with high mortality; this association was retained after adjusting for other covariates (second tertile hazard ratio 1.40, P = 0.152 vs. first tertile; third tertile hazard ratio 1.94, P = 0.005 vs. first tertile).
Conclusions
Urinary L‐FABP is more closely associated with tubular dysfunction than with glomerular dysfunction. Tubular dysfunction, which was evaluated based on urinary L‐FABP levels, in patients with AHF is associated with all‐cause mortality and is independent of pre‐existing risk factors. L‐FABP should be considered for use in the prognosis of AHF. Urinary liver-type fatty acid-binding protein (L-FABP) is expressed in proximal tubular epithelial cells and excreted into the urine during tubular injury. We hypothesized that high urinary L-FABP is associated with poor prognosis in patients with acute heart failure (AHF). We analysed 623 patients (74 ± 13 years old; 60.0% male patients) with AHF. Urinary L-FABP levels were measured at the time of admission and adjusted for the urinary creatinine concentration. The primary endpoint was all-cause mortality. The median value and interquartile range of urinary L-FABP levels were 6.66 and 3.37-21.1 μg/gCr, respectively. Urinary L-FABP levels were significantly correlated with both beta-2 microglobulin and cystatin C levels; the correlation with the former was higher than that with the latter. During the follow-up of 631 (interquartile range: 387-875) days, 142 deaths occurred. A high tertile of urinary L-FABP level was associated with high mortality; this association was retained after adjusting for other covariates (second tertile hazard ratio 1.40, P = 0.152 vs. first tertile; third tertile hazard ratio 1.94, P = 0.005 vs. first tertile). Urinary L-FABP is more closely associated with tubular dysfunction than with glomerular dysfunction. Tubular dysfunction, which was evaluated based on urinary L-FABP levels, in patients with AHF is associated with all-cause mortality and is independent of pre-existing risk factors. L-FABP should be considered for use in the prognosis of AHF. AimsUrinary liver‐type fatty acid‐binding protein (L‐FABP) is expressed in proximal tubular epithelial cells and excreted into the urine during tubular injury. We hypothesized that high urinary L‐FABP is associated with poor prognosis in patients with acute heart failure (AHF).Methods and resultsWe analysed 623 patients (74 ± 13 years old; 60.0% male patients) with AHF. Urinary L‐FABP levels were measured at the time of admission and adjusted for the urinary creatinine concentration. The primary endpoint was all‐cause mortality. The median value and interquartile range of urinary L‐FABP levels were 6.66 and 3.37–21.1 μg/gCr, respectively. Urinary L‐FABP levels were significantly correlated with both beta‐2 microglobulin and cystatin C levels; the correlation with the former was higher than that with the latter. During the follow‐up of 631 (interquartile range: 387–875) days, 142 deaths occurred. A high tertile of urinary L‐FABP level was associated with high mortality; this association was retained after adjusting for other covariates (second tertile hazard ratio 1.40, P = 0.152 vs. first tertile; third tertile hazard ratio 1.94, P = 0.005 vs. first tertile).ConclusionsUrinary L‐FABP is more closely associated with tubular dysfunction than with glomerular dysfunction. Tubular dysfunction, which was evaluated based on urinary L‐FABP levels, in patients with AHF is associated with all‐cause mortality and is independent of pre‐existing risk factors. L‐FABP should be considered for use in the prognosis of AHF. Abstract Aims Urinary liver‐type fatty acid‐binding protein (L‐FABP) is expressed in proximal tubular epithelial cells and excreted into the urine during tubular injury. We hypothesized that high urinary L‐FABP is associated with poor prognosis in patients with acute heart failure (AHF). Methods and results We analysed 623 patients (74 ± 13 years old; 60.0% male patients) with AHF. Urinary L‐FABP levels were measured at the time of admission and adjusted for the urinary creatinine concentration. The primary endpoint was all‐cause mortality. The median value and interquartile range of urinary L‐FABP levels were 6.66 and 3.37–21.1 μg/gCr, respectively. Urinary L‐FABP levels were significantly correlated with both beta‐2 microglobulin and cystatin C levels; the correlation with the former was higher than that with the latter. During the follow‐up of 631 (interquartile range: 387–875) days, 142 deaths occurred. A high tertile of urinary L‐FABP level was associated with high mortality; this association was retained after adjusting for other covariates (second tertile hazard ratio 1.40, P = 0.152 vs. first tertile; third tertile hazard ratio 1.94, P = 0.005 vs. first tertile). Conclusions Urinary L‐FABP is more closely associated with tubular dysfunction than with glomerular dysfunction. Tubular dysfunction, which was evaluated based on urinary L‐FABP levels, in patients with AHF is associated with all‐cause mortality and is independent of pre‐existing risk factors. L‐FABP should be considered for use in the prognosis of AHF. |
Author | Yatsu, Shoichiro Kasai, Takatoshi Maeda, Daichi Ishiwata, Sayaki Kato, Takao Matsue, Yuya Suda, Shoko Dotare, Taishi Nakamura, Yutaka Sunayama, Tsutomu Hiki, Masaru Minamino, Tohru |
AuthorAffiliation | 3 Department of Cardiology Osaka Medical and Pharmaceutical University Osaka Japan 1 Department of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo Japan 2 Cardiovascular Respiratory Sleep Medicine Juntendo University Graduate School of Medicine Tokyo Japan 4 Japan Agency for Medical Research and Development‐Core Research for Evolutionary Medical Science and Technology (AMED‐CREST) Japan Agency for Medical Research and Development Tokyo Japan |
AuthorAffiliation_xml | – name: 2 Cardiovascular Respiratory Sleep Medicine Juntendo University Graduate School of Medicine Tokyo Japan – name: 4 Japan Agency for Medical Research and Development‐Core Research for Evolutionary Medical Science and Technology (AMED‐CREST) Japan Agency for Medical Research and Development Tokyo Japan – name: 1 Department of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo Japan – name: 3 Department of Cardiology Osaka Medical and Pharmaceutical University Osaka Japan |
Author_xml | – sequence: 1 givenname: Tsutomu surname: Sunayama fullname: Sunayama, Tsutomu organization: Juntendo University Graduate School of Medicine – sequence: 2 givenname: Shoichiro surname: Yatsu fullname: Yatsu, Shoichiro email: yuya8950@gmail.com, syatsu@juntendo.ac.jp organization: Juntendo University Graduate School of Medicine – sequence: 3 givenname: Yuya orcidid: 0000-0003-2456-8525 surname: Matsue fullname: Matsue, Yuya email: yuya8950@gmail.com organization: Juntendo University Graduate School of Medicine – sequence: 4 givenname: Taishi surname: Dotare fullname: Dotare, Taishi organization: Juntendo University Graduate School of Medicine – sequence: 5 givenname: Daichi surname: Maeda fullname: Maeda, Daichi organization: Osaka Medical and Pharmaceutical University – sequence: 6 givenname: Sayaki surname: Ishiwata fullname: Ishiwata, Sayaki organization: Juntendo University Graduate School of Medicine – sequence: 7 givenname: Yutaka surname: Nakamura fullname: Nakamura, Yutaka organization: Juntendo University Graduate School of Medicine – sequence: 8 givenname: Shoko surname: Suda fullname: Suda, Shoko organization: Juntendo University Graduate School of Medicine – sequence: 9 givenname: Takao surname: Kato fullname: Kato, Takao organization: Juntendo University Graduate School of Medicine – sequence: 10 givenname: Masaru surname: Hiki fullname: Hiki, Masaru organization: Juntendo University Graduate School of Medicine – sequence: 11 givenname: Takatoshi surname: Kasai fullname: Kasai, Takatoshi organization: Juntendo University Graduate School of Medicine – sequence: 12 givenname: Tohru surname: Minamino fullname: Minamino, Tohru organization: Japan Agency for Medical Research and Development |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34921522$$D View this record in MEDLINE/PubMed |
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CitedBy_id | crossref_primary_10_1007_s00380_023_02269_2 crossref_primary_10_1111_iji_12654 crossref_primary_10_1007_s11428_023_01004_9 crossref_primary_10_1016_j_cca_2023_117465 crossref_primary_10_3390_diagnostics14050463 crossref_primary_10_1002_ehf2_14883 crossref_primary_10_1016_j_jtct_2023_10_003 crossref_primary_10_1007_s00380_023_02330_0 |
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Keywords | Urinary liver-type fatty acid-binding protein Tubular dysfunction Prognosis Beta-2 microglobulin Acute heart failure |
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Urinary liver‐type fatty acid‐binding protein (L‐FABP) is expressed in proximal tubular epithelial cells and excreted into the urine during tubular... Urinary liver-type fatty acid-binding protein (L-FABP) is expressed in proximal tubular epithelial cells and excreted into the urine during tubular injury. We... AimsUrinary liver‐type fatty acid‐binding protein (L‐FABP) is expressed in proximal tubular epithelial cells and excreted into the urine during tubular injury.... AIMSUrinary liver-type fatty acid-binding protein (L-FABP) is expressed in proximal tubular epithelial cells and excreted into the urine during tubular injury.... Abstract Aims Urinary liver‐type fatty acid‐binding protein (L‐FABP) is expressed in proximal tubular epithelial cells and excreted into the urine during... |
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SubjectTerms | Acute heart failure Aged Aged, 80 and over Beta‐2 microglobulin Biomarkers Biomarkers - metabolism Blood pressure Cardiovascular disease Chronic obstructive pulmonary disease Coronary vessels Datasets Diabetes Ejection fraction Enzymes Fatty Acid-Binding Proteins - metabolism Fatty acids Female Heart failure Heart Failure - metabolism Hemoglobin Human subjects Humans Hypertension Hypoxia Ischemia Liver Liver - metabolism Male Medical prognosis Medical research Middle Aged Mortality Original Patients Peptides Prognosis Proteins Regression analysis Tubular dysfunction Urinary liver‐type fatty acid‐binding protein Vein & artery diseases |
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Title | Urinary liver‐type fatty acid‐binding protein as a prognostic marker in patients with acute heart failure |
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