Intestinal Fatty Acid Binding Protein is Associated With Mortality in Patients With Acute Heart Failure or Cardiogenic Shock
| Autor: | Johann Wojta, Konstantin A. Krychtiuk, Georg Goliasch, Walter S. Speidl, Max Lenz, Kurt Huber, Stefan P. Kastl, Gottfried Heinz, Klaus Distelmaier |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Shock Cardiogenic 030204 cardiovascular system & hematology Fatty Acid-Binding Proteins Critical Care and Intensive Care Medicine Gastroenterology law.invention 03 medical and health sciences 0302 clinical medicine law Internal medicine medicine Humans Prospective Studies Prospective cohort study Aged Aged 80 and over Heart Failure Inflammation business.industry Cardiogenic shock Mortality rate 030208 emergency & critical care medicine Middle Aged medicine.disease Intensive care unit Shock (circulatory) Heart failure Acute Disease Emergency Medicine Biomarker (medicine) Female medicine.symptom business Perfusion Biomarkers |
| Zdroj: | Shock. 51:410-415 |
| ISSN: | 1540-0514 1073-2322 |
| DOI: | 10.1097/shk.0000000000001195 |
| Popis: | Background Acute heart failure and cardiogenic shock are associated with an impaired intestinal perfusion, which may lead to a release of cytoplasmatic proteins by hypoxic epithelial injury. Intestinal fatty acid binding protein (iFABP), highly specific for the small bowel enterocyte, may pose a useful novel and very sensitive biomarker for predicting outcome of these patients.The aim of this study was to investigate whether circulating levels of iFABP are associated with mortality in patients with acute heart failure or cardiogenic shock requiring intensive care unit (ICU) admission. Methods We included 90 consecutive patients with cardiogenic shock (74.4%) or severe acute heart failure (25.6%) admitted to a cardiac ICU. Blood samples were taken at day 0 and day 3. Median age was 64.7 (49.4-74.3), 76.7% of patients were male and median NT-proBNP levels were 4,986 (1,525-23,842) pg/mL. 30-day survival was 64.4%. Results Patients with serum levels of iFABP at day 0 in the highest quartile (iFABP ≥ 588.4 pg/mL) had a 2.5-fold risk (P = 0.02) of dying independent of demographics, NT-proBNP levels, and vasopressor use. Extensively elevated admission levels of iFABP above the 90th percentile (iFABP ≥ 10208.4 pg/mL) were associated with an excessive mortality rate of 88.9%. In contrast, iFABP levels at day 3 were not associated with outcome. Conclusion Circulating levels of iFABP at admission predict mortality. This suggests that early inadequate perfusion of the small intestine may be associated with a dramatically decreased survival in patients with cardiogenic shock or severe acute heart failure. |
| Databáze: | OpenAIRE |
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