Comparison of a qualitative measurement of heart-type fatty acid-binding protein with other cardiac markers as an early diagnostic marker in the diagnosis of non-ST-segment elevation myocardial infarction

Cardiovasc J Afr. 2015 Nov-Dec;26(6):204-9. doi: 10.5830/CVJA-2015-028. Epub 2015 Jul 14.

Abstract

Objective: Heart-type fatty acid-binding protein (H-FABP) is a novel cardiac marker used in the early diagnosis of acute myocardial infarction (AMI), which shows myocyte injury. Our study aimed to compare bedside H-FABP measurements with routine creatine kinase-MB (CK-MB) and troponin I (TnI) tests for the early diagnosis of non-ST-elevation MI (NSTEMI), as well as for determining its exclusion capacity.

Methods: A total of 48 patients admitted to the emergency room within the first 12 hours of onset of ischaemic-type chest pain lasting more than 30 minutes and who did not have ST-segment elevation on electrocardiography (ECG) were included in the study. Definite diagnoses of NSTEMI were made in 24 patients as a result of 24-hour follow up, and the remaining 24 patients did not develop MI.

Results: When various subgroups were analysed according to admission times, H-FABP was found to be a better diagnostic marker compared to CK-MB and TnI (accuracy index 85%), with a high sensitivity (79%) and specificity (93%) for early diagnosis ( ≤ six hours). The respective sensitivities of bedside H-FABP and TnI tests were 89 vs 33% (p < 0.05) for patients presenting within three hours of onset of symptoms.

Conclusion: Bedside H-FABP measurements may contribute to correct early diagnoses, as its levels are elevated soon following MI, and measurement is easy, with a rapid result.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Angina Pectoris / etiology
  • Biomarkers / blood
  • Creatine Kinase, MB Form / blood
  • Early Diagnosis
  • Fatty Acid Binding Protein 3
  • Fatty Acid-Binding Proteins / blood*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / blood*
  • Myocardial Infarction / complications
  • Myocardial Infarction / diagnosis*
  • Point-of-Care Testing
  • Predictive Value of Tests
  • Prognosis
  • Reproducibility of Results
  • Time Factors
  • Troponin I / blood
  • Up-Regulation

Substances

  • Biomarkers
  • FABP3 protein, human
  • Fatty Acid Binding Protein 3
  • Fatty Acid-Binding Proteins
  • Troponin I
  • Creatine Kinase, MB Form