Prognostic relevance of plasma heart-type fatty acid binding protein after out-of-hospital cardiac arrest

• We checked plasma H-FABP levels in resuscitated cardiac arrest patients.
• H-FABP levels at 24 h were correlated to the duration of cardiac arrest.
• H-FABP level at 24 h was a better marker than troponin I in predicting outcome.
• H-FABP level at 24 h was an independent predictor for the survival outcome.
• Early prognosis for cardiac arrest could be improved by incorporating H-FABP level.

ObjectiveHeart-type fatty acid binding protein (H-FABP) is a tissue-specific protein which is rapidly released into the circulation when cardiomyocyte injury occurs. The aim of the study is to investigate the prognostic relevance of H-FABP for out-of-hospital cardiac arrest (OHCA) patients in the early post-cardiac arrest period.Design and methodsThis is a prospective cohort study enrolling non-traumatic resuscitated OHCA patients.ResultsA total of 106 patients were enrolled. The H-FABP level at 24 h was correlated to the duration from collapse to return of spontaneous circulation (p < 0.001, R2 = 0.549). The outcomes of survival to discharge were worse in the patient group with the higher tertile of plasma H-FABP level at 24 h after the event (p = 0.011). Multivariate analysis demonstrated that the significant predictors for in-hospital mortality were APACHE II score (p = 0.010), gender (p = 0.025) and the tertiles of H-FABP at 24 h with hazard ratios for the lowest, middle, and highest tertiles being 1.0, 1.157 (95% confidence interval 0.435–3.075, p = 0.770), and 2.840 (95% confidence interval 1.137–7.092, p = 0.025), respectively.ConclusionThe plasma level of H-FABP at 24 h after the event may be an early and independent factor associated with survival to discharge in OHCA patients.