The Prognostic and Risk-Stratified Value of Heart-Type Fatty-Acid-Binding Protein in Community Acquired Pneumonia in Emergency Department

OBJECTIVE To evaluate the prognostic and risk stratified ability of heart-type fatty-acid-binding protein (H-FABP) in patients with community acquired pneumonia (CAP) in emergency department (ED) and to compare it with Pneumonia Severity Index (PSI) and CURB-65. METHODS Consecutive adult CAP patients admitted to the ED of Beijing Chao-Yang Hospital were enrolled. Circulating H-FABP and troponin I were measured. PSI and CURB-65 were calculated in all patients. The differences in 28-day mortality and requirement for mechanical ventilation (MV) or a vasopressor within 6 h after ED arrival were compared in patients with positive H-FABP (≥7 ng/mL) and negative ones (<7 ng/mL). Receiver operating characteristic (ROC) curve and logistic regression were used to assess the predictive value of H-FABP. RESULTS From August to November 2012, 229 CAP patients were enrolled. The 28-day mortality, PSI, CURB-65, and incidence of using MV or a vasopressor were much higher in H-FABP-positive patients than in negative ones (P < 0.01). H-FABP was an independent predictor of the 28-day mortality. The area under the ROC curve (AUC) of H-FABP was 0.751. Combination of H-FABP and CURB-65 (AUC = 0.824) or H-FABP and PSI (AUC = 0.820) improved their prognostic performance. CONCLUSIONS H-FABP was valuable for prognosis and risk stratification in CAP patients in ED.