Key result
Rapid h-FABP testing detects early ACS with ~94% sensitivity, outperforming troponin I.
Why the study?
Does h-FABP rapid test improve early diagnostic sensitivity compared to Cardiac Troponin I in patients with ACS presenting within six hours?
Cross-Sectional (n=75)
No
Does h-FABP rapid test improve early diagnostic sensitivity compared to Cardiac Troponin I in patients with ACS presenting within six hours?
Absolute Event Rate: 93.5% vs 60.9%
The h-FABP rapid test offers higher sensitivity than Troponin I for the early diagnosis of NSTEMI within the first six hours of symptom onset.
May aid early ACS diagnosis when troponin is normal; hypothesis-generating and requires validation before any clinical use.
Acute coronary syndrome (ACS) is caused by atherosclerotic plaque rupture and microembolization which lead to decreased oxygensupply into the myocardium. Generally, ACS includes an unstable angina (UA), non ST elevation myocardial infarction (NSTEMI) andST elevation myocardial infarction. ACS may lead to ST elevation Myocardial Infarction (STEMI) and finally a sudden death. Cardiactroponin is used routinely for diagnosing acute coronary syndrome (ACS); however, troponin is not elevated in the initial hours ofACS”precluding their usefulness in the early diagnosis. The aim of this study is to determine the diagnostic value of h-FABP Rapid testin relation to Cardiac Troponin I in NSTEMI. Seventy five patients with ACS were enrolled in this study. All patients presented symptomswithin six hours of the onset and suffered typical chest pain. Blood samples were obtained for rapid test h-FABP (cardiodetect) andTroponin I (tropospot). The h-FABP showed a 93.5% sensitivity, 95% CI: 81.1–98.3 and 82.8% specificity, 95% CI: 63.5–93.5, PositivePredictive Value 89.6%, 95% CI: 76.6–96.1, Negative Predictive Value 88.9%, 95% CI: 69.7–97.1, respectively in the first six hours.Troponin I had a 60.9% sensitivity, 95% CI: 45.4–74.5 and 96.6% specificity, 95% CI: 80.4–99.8, Positive Predictive Value 96.6%,95% CI: 80.4–99.8, Negative Predictive Value 60.9%, 95% CI: 45.4–74.5, respectively in the first six hours. Based on this study resulton patients with Non ST Elevation Myocardial Infarction (NSTEMI), it is suggested to determine the h-FABP as well. For this purpose,point-of-care h-FABP test can be utilized, as it has the advantage of highly sensitivity and specificity, beside it can carry on a bedsidetesting and show a rapid test results as well.
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Marpaung et al. (2018) conducted a cross-sectional in Acute Coronary Syndrome (NSTEMI and UA) (n=75). h-FABP rapid test vs. Troponin I rapid test was evaluated on Sensitivity for diagnosing acute coronary syndrome within 6 hours of symptom onset (95% CI 81.1-98.3). The h-FABP rapid test demonstrated a higher sensitivity of 93.5% compared to 60.9% for Troponin I in diagnosing acute coronary syndrome within the first six hours of chest pain onset.
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