Diagnostic and prognostic utility of heart-type fatty acid binding proteins in cardiovascular diseases and risk factors − an updated review of the literature

Fatty acid-binding proteins (FABPs) are intracellular lipid-binding proteins that significantly contribute to the transport and metabolism of long-chain fatty acids and other hydrophobic ligands. In this review, we focus on the role of heart-type FABP (H-FABPs) as diagnostic and prognostic biomarkers in several cardiovascular diseases. Despite its advantages over troponins and other cardiac biomarkers, H-FABP remains underutilized in clinical practice. The aim of this review is to reassess the role of H-FABPs across various cardiovascular pathologies and promote their adoption into standard clinical practice. Elevated H-FABP levels have been associated with worse outcomes in CAD and serve as sensitive markers for myocardial injury during the early stages of MI and reperfusion. Furthermore, we discuss the potential of H-FABPs in risk stratification for stable CAD and their utility in predicting long-term outcomes post-MI. The prognostic value of H-FABP in cardiac events such as heart failure, pulmonary embolism, and arrhythmias, alongside its application in peripheral arterial disease and non-ischemic dilated cardiomyopathy, highlights its importance in cardiovascular medicine. Given the global burden of cardiovascular diseases, understanding and utilising H-FABPs could enhance patient management through better risk assessment and early diagnosis.