ArticleClinical and translational science2026
Incremental Prognostic Value of Heart-Type Fatty Acid Binding Protein in Patients With Light Chain Cardiac Amyloidosis: A Prospective Cohort Study.
Article in Clinical and translational science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
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.
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