BACKGROUND Heart-type fatty acid-binding protein (H-FABP) is a novel marker of myocardial injury and has been reported to be associated with cardiovascular diseases (CVD) including patients with diabetes mellitus (DM). Unfortunately, its prognostic value in patients with CVD and impaired glucose metabolism (IGM) is unclear. The objective of this study was to investigate the prognostic value of H-FABP in CVD patients with IGM. METHODS A total of 4594 patients with angiography-proven coronary artery disease (CAD) were enrolled and divided into subgroup according to glucose metabolism status (normal glucose regulation [NGR], pre-DM, and DM). Baseline levels of H-FABP were measured using latex immunoturbidimetric method. The cardiovascular events (CVE) were defined as cardiovascular death, myocardial infarction, stroke and coronary revascularization. Cox regression and Kaplan-Meier analysis were used to evaluate the relations of H-FABP and glucose metabolism status to CVEs. RESULTS During the follow-up period with up to 7.1 years, 380 CVEs occurred. Patients with CVE had higher levels of H-FABP compared to those without CVE (p < 0.001). Interestingly, H-FABP levels were also elevated in DM and pre-DM groups compared with NGR group (p < 0.001), when combined glucose metabolism status with H-FABP stratification, patients in the highest tertile of H-FABP appeared to have higher risk of CVEs with pre-DM (adjusted hazard ratio [HR]: 1.855, 95% confidential intervals [CIs] 1.076-3.214; p = 0.033) and DM (adjusted HR: 2.560, 95% CIs 1.409-4.650; p = 0.002). The Kaplan-Meier curve indicated that DM patients with the highest H-FABP levels were associated with the greatest risk of CVEs (p < 0.05). CONCLUSIONS Our data firstly showed that elevated H-FABP levels were associated with worse outcomes in CAD patients with pre-DM and DM, which provided the novel information that H-FABP might be a prognostic marker for clinical outcomes among patients with CAD and IGM.

中文翻译：

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心脏型脂肪酸结合蛋白对稳定冠状动脉疾病和葡萄糖代谢受损的患者的预后作用：一项队列研究。

背景技术心脏型脂肪酸结合蛋白（H-FABP）是心肌损伤的新标志，并且据报道与包括糖尿病患者（DM）的心血管疾病（CVD）有关。不幸的是，尚不清楚其在患有CVD和葡萄糖代谢受损（IGM）的患者中的预后价值。这项研究的目的是调查H-FABP在IGM的CVD患者中的预后价值。方法纳入4594例经血管造影证实的冠状动脉疾病（CAD）患者，并根据葡萄糖代谢状况（正常葡萄糖调节[NGR]，DM前和DM）将其分为亚组。使用乳胶免疫比浊法测量H-FABP的基线水平。心血管事件（CVE）定义为心血管死亡，心肌梗塞，中风和冠状动脉血运重建。Cox回归和Kaplan-Meier分析用于评估H-FABP和葡萄糖代谢状况与CVE的关系。结果在长达7.1年的随访期内，发生了380例CVE。与没有CVE的患者相比，患有CVE的患者的H-FABP水平更高（p <0.001）。有趣的是，与NGR组相比，DM组和DM前组的H-FABP水平也升高（p <0.001），当葡萄糖代谢状态与H-FABP分层相结合时，H-FABP最高三分位数的患者似乎更高DM前（调整后的危险比[HR]：1.855，95％可信区间[CIs] 1.076-3.214; p = 0.033）和DM（调整后的HR：2.560，95％CIs 1.409-4.650; p = 0.002）的CVE风险）。Kaplan-Meier曲线表明，H-FABP水平最高的DM患者发生CVE的风险最高（p <0。05）。结论我们的数据首先显示，DM前DM和DM的CAD患者H-FABP水平升高与预后较差有关，这提供了新的信息，即H-FABP可能是CAD和IGM患者临床预后的标志。