Cerebrospinal fluid heart fatty acid‐binding protein as a predictive biomarker of neurodegeneration in Alzheimer’s disease

Objective This study aims to investigate whether the heart fatty acid‐binding protein (HFABP) in the cerebrospinal fluid (CSF) was a potential predictive biomarker for Alzheimer’s disease (AD). Methods We evaluated the associations of CSF HFABP levels with core biomarkers, cognition, and brain structure in a sample population (n = 302) from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. Multiple linear regression and mixed‐effects models were employed in the analyses. AD progression was assessed using the Kaplan–Meier survival analysis. Results CSF HFABP was higher in patients with mild cognitive impairment and AD than the normal controls (p < 0.001) and was particularly higher in those with amyloid‐β (Aβ) pathologic features. CSF HFABP was associated with higher baseline CSF t‐tau (p < 0.001), CSF p‐tau (p < 0.001), and CSF t‐tau/Aβ42 and CSF p‐tau/Aβ42 (p < 0.01). Moreover, CSF HFABP was found to play predictive roles in hippocampal atrophy (p < 0.01), cognitive decline (p < 0.05), and the risk of AD (p < 0.001). Conclusion Our findings suggest that CSF HFABP can be a predictive biomarker of AD.