Baseline H-FABP > 9.5 ng/mL was independently associated with an increased risk of all-cause mortality in patients with light chain cardiac amyloidosis (adjusted HR 2.79; 95% CI 1.49-5.22; p=0.001).
Cohort (n=84)
No
Does elevated baseline H-FABP predict increased all-cause mortality in patients with light chain cardiac amyloidosis?
Elevated H-FABP (> 9.5 ng/mL) is an independent predictor of all-cause mortality in light chain cardiac amyloidosis and provides incremental prognostic value over established Mayo staging systems.
Effect estimate: HR 2.79 (95% CI 1.49-5.22)
p-value: p=0.001
The utility of heart-type fatty acid binding protein (H-FABP) as a prognostic biomarker in light chain cardiac amyloidosis (AL-CA) patients remains unestablished. Consecutive patients diagnosed with AL-CA in the Heart Failure Center; Fuwai Hospital were enrolled. Baseline H-FABP levels categorized patients as low (≤ 9.5 ng/mL) or high (> 9.5 ng/mL) group. Kaplan-Meier analysis and Cox proportional hazards models were performed. Model performance was assessed using Harrell's C concordance index (C-index), integrated discrimination improvement (IDI) index, and net reclassification improvement (NRI) index. Eighty-four patients were included (mean age 60.12 ± 11.25 years; 32.1% female), with 30 (35.7%) in the high H-FABP group. Overall survival was significantly lower in the high H-FABP group. In multivariable Cox models adjusted for age, eGFR and chemotherapy, H-FABP > 9.5 ng/mL remained independently associated with an increased risk of all-cause mortality when incorporating either the European modified Mayo 2004 stages adjusted hazard ratio (HR): 2.79, 95% confidence interval (CI): 1.49-5.22; p = 0.001 or the revised Mayo 2012 stages (HR: 2.67, 95% CI: 1.48-4.83; p = 0.001). Adding H-FABP levels significantly improved predictive performance across both baseline staging systems. For the European modified Mayo 2004 stage, the C-index increased from 0.622 to 0.663, accompanied by positive IDI (0.053) and NRI (0.294). Similarly, for the revised Mayo 2012 stage, the C-index increased from 0.611 to 0.660, with positive IDI (0.074) and NRI (0.308). Elevation of H-FABP is associated with an increased risk of all-cause mortality in patients with AL-CA. It provides significant additive prognostic value to the established staging system for prognosis in AL-CA.
Li et al. (Wed,) conducted a cohort in light chain cardiac amyloidosis (AL-CA) (n=84). High H-FABP (> 9.5 ng/mL) vs. Low H-FABP (≤ 9.5 ng/mL) was evaluated on all-cause mortality (HR 2.79, 95% CI 1.49-5.22, p=0.001). Baseline H-FABP > 9.5 ng/mL was independently associated with an increased risk of all-cause mortality in patients with light chain cardiac amyloidosis (adjusted HR 2.79; 95% CI 1.49-5.22; p=0.001).