Why the study?
Early diagnosis and management of ACS are critical to reduce morbidity and mortality, but the diagnostic accuracy of H-FABP compared with hs-TnI and/or ischemic ECG findings required evaluation.
Does H-FABP measurement improve the early diagnosis of Acute Coronary Syndrome compared to hs-TnI and/or ECG in patients presenting with suspected angina?
Does H-FABP measurement improve the early diagnosis of Acute Coronary Syndrome compared to hs-TnI and/or ECG in patients presenting with suspected angina?
H-FABP is a highly sensitive biomarker that may serve as a useful adjunct to hs-TnI for the early diagnosis of acute coronary syndrome, particularly within the first 3 hours of symptom onset.
May support H-FABP for very early ACS detection; hypothesis-generating and requires prospective validation versus hs-TnI.
Background: Heart Type Fatty Acid Binding Protein (H-FABP) is a biomarker suggested for early detection of Acute Coronary Syndrome (ACS). Early diagnosis and management are critical as it could prevent and reduce morbidity and mortality. The study aimed to determine the diagnostic accuracy of H-FABP as a biomarker of ACS compared to gold standard high-sensitivity Troponin I (hs–TnI) and/or ECG findings suggesting ischemia. Methods: The study was conducted from May 2020 to November 2020 at Dr. Ziauddin University Hospital in Karachi. Blood samples of 154 patients were collected, who presented to an emergency department or admitted to the Cardiac Care Unit more than 18 years of age with symptoms suggesting angina as pain in the chest, left arm/lower jaw, increased heart rate and shortness of breath. Patient data regarding age, gender, duration of chest pain onset, kidney disease, diabetes mellitus, hypertension and smoking were collected. Serum H-FABP was analyzed on a Quantitative Fluorescence immunoassay Analyzer. Diagnostic accuracy statistics for H-FABP were calculated with the help of contingency tables taking hs-TnI and/or ECG findings as a gold standard. Results: Overall H-FABP showed sensitivity (91.0%), specificity (76.7%), PPV (90.9%), NPV (76.7%) and diagnostic accuracy was 87.58%. H-FABP demonstrated an Area Under Curve (0.911, 95% C.I:0.850-0.972, p<0.001), higher than that of hs-TnI (0.908, 95% C.I:0.844-0.971, p<0.001) in patients having chest pain for 3 hours or less, at the cost of specificity. Conclusion: H-FABP is a more sensitive biomarker than hs-TnI in the early diagnosis of ACS (p<0.001). However, being less specific, it can be used as an adjuvant cardiac biomarker for early diagnosis of ACS.
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A 2023 study studied this question.
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