RESUMEN
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. 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. 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. 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