Abstract 15725: Heart-Type Fatty Acid Binding Protein for Risk Stratification in Patients With Pulmonary Embolism: A Meta-Analysis

Background: The role of heart- type fatty acid binding protein(H-FABP) in risk stratification of acute pulmonary embolism is still undefined. We performed a meta-analysis of studies in patients with acute pulmonary embolism to assess the prognostic value of elevated H-FABP levels for short-term adverse outcomes. Methods: Two independent reviewers systematically searched “Pubmed”, “ Embase” and “Cochrane” database using the mesh word “heart type fatty acid binding protein” and “pulmonary embolism” through June 2014 . Additionally conference abstracts, review articles and bibliographies were searched. Prospective studies were included if those were done on hemodynamically stable pulmonary embolism patients and they had used H-FABP assay. Primary end point was 30 day adverse outcomes. Adverse outcomes were defined as composite of death, endotracheal intubation, pressors infusion cardiopulmonary resuscitation, or recurrent pulmonary embolism. A random-effects model was used to pool study results and I 2 testing was used to test for heterogeneity. Results: Six studies including 1460 patients were included in the analysis. Overall, 66 out of 366 patients with elevated H-FABP levels had adverse 30 day outcomes(19.6%) as compared to 47 out of 1094 in normal H-FABP levels(4.3%). Elevated H-FABP levels were significantly associated with increased adverse outcomes events (odds ratio [OR], 8.37; 95% CI, 3.08 to 22.68, I 2 = 75%). Only 2 out of 6 studies reported separate mortality data. 30 day mortality was significantly increased in elevated H-FABP levels group compared to normal H-FABP levels group(odds ratio[OR], 37.81; 95% CI, 2.21 to 646.77, I 2 =82%). There was significant heterogeneity among studies for both outcomes. Conclusions: Elevated H-FABP levels identify patients with hemodynamically stable pulmonary embolism at high risk for short term adverse outcomes and death.