Investigation of the relationship between the clinical classification of pulmonary embolism and heart-type fatty acid–binding protein (H-FABP)

Pulmonary embolism (PE) is a life-threatening clinical condition with a high risk of mortality, in which early and accurate risk stratification is essential. The aim of this study was to investigate the prognostic role of Heart-Type Fatty Acid Binding Protein (H-FABP) levels in clinical classification and in predicting severe pulmonary embolism, and to evaluate the relationship between troponin and pro-brain natriuretic peptide (pro-BNP) levels and disease severity and prognosis. A total of 92 patients diagnosed with acute pulmonary embolism were included in the study. The mean age of the patients was 64.1 ± 10.2 years, with a gender distribution of 53.3% females (n=49) and 46.7% males (n=43). Due to the limited number of non-massive cases, clinical classification was performed by grouping patients as massive and submassive+non-massive PE. ROC analysis revealed that troponin (AUC=0.673; p=0.005) and pro-BNP (AUC=0.657; p=0.011) levels had statistically significant discriminatory power in predicting severe pulmonary embolism. In contrast, the AUC value for H-FABP was 0.610 and did not reach statistical significance (p=0.074), suggesting that H-FABP did not demonstrate a significant prognostic value in predicting severe pulmonary embolism in this study. Correlation analysis with the Pulmonary Embolism Severity Index (PESI) demonstrated significant positive associations between troponin and pro-BNP levels and clinical severity, whereas no significant correlation was observed between H-FABP levels and the PESI score. Overall, these findings indicate that troponin and pro-BNP are valuable biomarkers associated with disease severity in pulmonary embolism. The lack of significant prognostic value of H-FABP in this study may be related to its sensitivity to sampling time due to its biological release kinetics, as well as the relatively limited sample size. Therefore, larger and methodologically robust studies are required to more clearly define the potential prognostic role of H-FABP in pulmonary embolism.