Heart-Type Fatty Acid-Binding Protein in the Early Diagnosis of Acute Myocardial Infarction The potential for influencing patient management
Journal Title: Sultan Qaboos University Medical Journal - Year 2010, Vol 10, Issue 1
Abstract
Te objective of this study was to evaluate the diagnostic value of heart-type fatty acidbinding protein (H-FABP) in patients with acute chest pain and compare it with standard cardiac markers. Methods: We undertook a prospective evaluation of 100 consecutive patients admitted with acute chest pain suggestive of acute coronary syndromes (ACS). Serum cardiac troponin I (cTnI), cardiac troponin T (cTnT), creatine kinaseMB (CK-MB) mass, myoglobin, and H-FABP were determined at presentation and 2, 4, 8–10, and 16–24 hours after presentation. Te main outcome measure was the best sensitivity value within 6 hours after symptom onset. Results: H-FABP peak concentration occurred at 8 hours after symptoms onset and was the most sensitive early marker with 79.9% and 98% of patients with AMI identifed at presentation and 2 hours after presentation respectively. Te sensitivity of all other cardiac markers (CK-MB mass, cTnI, cTnT, and myoglobin) at presentation was < 62%. Te negative predictive value of H-FABP (94%) was also superior to other markers within the frst 2 hours of presentation. Myoglobin was the second most sensitive early marker at presentation. Peak sensitivity of cTnI, CK-MB mass, and cTnT were present at 4, 8–10, and 8–10 hours respectively after presentation. Conclusion: Combined measurement of H-FABP and cTnI on two occasions during the frst 8 hours after symptom onset was sufciently sensitive and specifc for the early diagnosis of most patients with acute MI and may provide advantages over other cardiac marker combinations.
Authors and Affiliations
Hafdh A Alhadi| Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman, Keith A A Fox| University of Edinburgh Cardiovascular Research Unit, Royal Infrmary of Edinburgh, UK
Keywords
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