Key result
H-FABP testing within the first 4 hours of symptom onset demonstrated significantly higher sensitivity for detecting acute myocardial infarction compared to cardiac Troponin T (77% vs 20%, p<0.05).
Why the study?
Does H-FABP measurement improve the early diagnosis of acute myocardial infarction compared to cardiac Troponin T in patients with acute ischemic chest pain?
Observational (n=50)
No
Does H-FABP measurement improve the early diagnosis of acute myocardial infarction compared to cardiac Troponin T in patients with acute ischemic chest pain?
Absolute Event Rate: 77% vs 20%
p-value: p=<0.05
H-FABP is a highly sensitive biomarker that can detect acute myocardial infarction earlier than cardiac Troponin T within the first 4 hours of symptom onset.
Should not yet change early AMI protocols; hypothesis-generating and requires randomized validation.
BACKGROUND AND OBJECTIVE: At very early stages of acute myocardial infarction (AMI), highly sensitive biomarkers are still lacking. Human heart-type fatty acid- binding protein (H-FABP) has a high potential as an early marker for acute myocardial infarction (AMI) being more sensitive than current routine cardiac markers. The objective of this study is to determine the efficacy of a newly developed qualitative test to measure H eart- type fatty acid-binding protein (H-FABP) levels in the blood for the early diagnosis of acute myocardial infarction (AMI) in patients with chest pain and compared with cardiac Troponin T. DESIGN: Prospective study. METHODS: Fifty patients with acute ischemic-type chest pain were prospectively enrolled and classified according to the American Heart Association/American College of Cardiology guidelines. An initial blood sample was obtained for H-FABP, cTnT, and CK-MB (first 4 hours of symptoms). After 4 hours (4 - 12 hours), repeat samples of H-FABP, cTnT, and CK-MB were obtained. RESULTS: Fifty patients presenting to hospital with a median symptom onset of 3.3 hrs (IQR 2-6 h) were enrolled in this study and 38 (76%) had AMI. At presentation, H-FABP gave the highest sensitivity of 77% (95% CI: 60.7-88.9) and specificity of 91% (95% CI: 58.7-99.8) and troponin T (cTnT) gave the highest specificity of 100% (95% CI: 69.2-100). This study demonstrated that H-FABP immunotest gave a better diagnostic classification at the early stage. Also, AMI was identified significantly earlier by H-FABP than cTnT (29 vs. 8 patients, p<0.05). CONCLUSIONS: Assessment of Heart-type fatty acid-binding protein (H-FABP) within the first 4 h of symptoms is superior to cTnT for detection of AMI, and is a useful additional biomarker for patients with acute ischemic chest pain.
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Ramaiah et al. (2013) conducted an observational in Suspected acute myocardial infarction (n=50). Heart-type fatty acid-binding protein (H-FABP) testing vs. Cardiac Troponin T (cTnT) testing was evaluated on Sensitivity for detection of acute myocardial infarction within 4 hours of symptom onset (95% CI 60.7-88.9, p=<0.05). H-FABP testing within the first 4 hours of symptom onset demonstrated significantly higher sensitivity for detecting acute myocardial infarction compared to cardiac Troponin T (77% vs 20%, p<0.05).
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