Diabetic Patients Have Increased Perioperative Cardiac Risk in Heart-Type Fatty Acid-Binding Protein-Based Assessment

Objective: To test the potential role of heart-type fatty acidbinding 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 HFABP 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 HFABP levels could alert clinicians to increased perioperative cardiovascular risk and could prevent underdiagnosis, especially in diabetic patients.