Plasma heart-type fatty acid-binding protein, omega-3 fatty acids and adverse cardiac events in the general population.

BACKGROUND

Heart-type fatty acid-binding protein (H-FABP), a principal intracellular transporter of long-chain fatty acids (FAs), has been investigated as an early diagnostic biomarker for acute myocardial infarction (MI) and acute coronary syndrome. However, evidence regarding its associations with long-term risk of cardiac events and potential interaction with omega-3 FAs remains scarce. Therefore, we aimed to investigate these associations in the general population.

METHODS

This study included 42 392 participants from the UK Biobank who were free of coronary heart disease (CHD) and heart failure (HF) at baseline. Plasma levels of H-FABP were quantified using the Olink platform. Multivariable Cox regression was used to evaluate the associations of H-FABP with incident CHD and HF, considering potential interaction with omega-3 FAs.

RESULTS

Elevated H-FABP levels were consistently associated with a higher risk of CHD (HR T3 vs T1=1.29), MI (HR T3 vs T1=1.54), CHD-related mortality (HR T3 vs T1=2.04) and HF (HR T3 vs T1=1.95) (all P-trend values <0.001). These associations appeared to be modified by plasma levels of omega-3 FAs, especially so for CHD (P-interaction=0.014) and MI (P-interaction=0.003). Comparing the extreme tertiles of H-FABP, HRs (95% CI) of CHD and MI were 1.41 (1.15 to 1.74) and 2.23 (1.57 to 3.15), respectively, among participants with lower omega-3 FAs, and 1.15 (0.96 to 1.38) and 1.11 (0.83 to 1.50), respectively, among those with higher omega-3 FAs.

CONCLUSIONS

Higher plasma levels of H-FABP were associated with a higher risk of CHD and HF in the general population, predominantly among individuals with low levels of omega-3 FAs.