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. 2015;24(1):53-7.
doi: 10.1159/000368756. Epub 2014 Nov 29.

Diabetic patients have increased perioperative cardiac risk in heart-type fatty acid-binding protein-based assessment

Munevver Sari  1 , Harun Kilic, Ozlem Karakurt Ariturk, Nuray Yazihan, Ramazan Akdemir
Affiliations

Diabetic patients have increased perioperative cardiac risk in heart-type fatty acid-binding protein-based assessment

Munevver Sari et al. Med Princ Pract. 2015.

Abstract

Objective: To test the potential role of heart-type fatty acid-binding protein (H-FABP) in detecting increased perioperative cardiac risk in comparison with cardiac troponin I (cTnI) in the early postoperative period.

Subjects and methods: Sixty-seven patients who had clinical risk factors and underwent elective intermediate - or high-risk noncardiac surgery were included in this study. Serum specimens were analyzed for H-FABP and cTnI levels before and at 8 h after surgery. None of the patients had chest pain; 27 had a history of ischemic heart disease, 3 of heart failure, 5 of cerebrovascular diseases, 40 of diabetes and 46 of hypertension.

Results: The mean duration of the operations was 2.33 ± 1.27 h (range 1-6). In the postoperative period, 27 (40.3%) patients had increased H-FABP levels (≥7.5 ng/ml); the median preoperative serum H-FABP level was 0.13 ng/ml (<0.1-5.9) and the median postoperative H-FABP level was 6.86 ng/ml (<0.1-13.7). Only 1 (1.5%) patient had cTnI >0.1 µg/l during the postoperative period. Correlation analysis revealed that the presence of diabetes was associated with an increased H-FABP level (r = 0.30, p = 0.01). Of the 27 patients with H-FABP ≥7.5 ng/ml, 21 (87%) had diabetes. There was no significant correlation with other clinical risk factors, type or duration of surgery.

Conclusion: The H-FABP levels significantly increased in the postoperative period. Most patients with increased postoperative H-FABP levels were diabetic. High H-FABP levels could alert clinicians to increased perioperative cardiovascular risk and could prevent underdiagnosis, especially in diabetic patients.

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Figures

Fig. 1
Fig. 1
Preoperative (0.13 ng/ml; 95% CI <0.1-5.9) and postoperative (6.86 ng/ml; 95% CI <0.1-13.7) H-FABP levels.
Fig. 2
Fig. 2
Plot showing every patient's preoperative and postoperative H-FABP levels.
See this image and copyright information in PMC

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