737–1 Heart Fatty Acid-binding Protein and Myoglobin can Accurately Detect Successful Reperfusion as Early as 15 Minutes After Reperfuslon

Human heart fatty acid-binding protein (FABP) is an abundant low molecular weight protein in cytoplasm of myocardial cell similar to myoglobin (Mb). To evaluate whether FABP can also detect successful reperfusion very early like Mb, we examined serum FABP and Mb levels in 45 patients (pts) undergoing PTCR or PTCA within 6 hours after the onset of acute myocardial infarction. Coronary angiography was performed every 5minutes (min) during reperfusion therapy to determine the exact time of reperfusion. In 30 pts with reperfusion (reperfused group: TIMI grade 3 [23 pts] and grade 2 [7 pts]), serum samples were taken just before and at 15, 30 and 60min after initial angiographic confirmation of reperfusion. In 15 pts without reperfusion (nonreperfused group), serum samples were taken just before and at 15, 30 and 60min after the initiation of therapy. FABP was measured by competitive enzyme immunoassay and Mb by latex agglutination turbidimetry. The FABP ratio (FABP after/FABP before) and Mb ratio (Mb after/Mb before) were calculated. FABP and Mb levels increased rapidly, peaked within 60min after reperfusion. The FABP and Mb ratios in the reperfused group significantly (p<0.01) exceeded those in the nonreperfused group at 15, 30 and 60 min. The sensitivity (Sen) and specificity (Spe) of these markers for reperfusion were as follows:Criteria15 min30 min60 minSenSpeSenSpeSenSpeFABP ratio>1.6*93%100%97%100%100%100%Mb ratio>2.4**90%100%93%100%100%100%*mean +2SD at 60 min in the nonreperfused group**published criteriaConclusionFABP, like Mb could accurately detect successful reperfusion as early as 15min after reperfusion and could provide a high level of accuracy within 60min after reperfusion

Association of blood pressure and renal outcome in patients with chronic kidney disease; a post hoc analysis of FROM-J study

It is well-known that hypertension exacerbates chronic kidney disease (CKD) progression, however, the optimal target blood pressure (BP) level in patients with CKD remains unclear. This study aimed to assess the optimal BP level for preventing CKD progression. The risk of renal outcome among different BP categories at baseline as well as 1 year after, were evaluated using individual CKD patient data aged between 40 and 74 years from FROM-J [Frontier of Renal Outcome Modifications in Japan] study. The renal outcome was defined as >= 40% reduction in estimated glomerular filtration rate to130 mmHg group. A significant increase in the renal outcome was found only in the group of diastolic BP >= 90 mmHg. The group of BP= 130 mmHg at baseline. Targeting SBP level<130 mmHg would be associated with the preferable renal outcome.Clinical Trial Registration-URL: https://www.umin.ac.jp/ctr/. Unique identifier: UMIN000001159 (16/05/2008)