Heart-Type Fatty Acid-Binding Protein in the Early Diagnosis of Acute Myocardial Infarction: the potential for influencing patient management

Objectivesthe objective of this study was to evaluate the diagnostic value of heart-type fatty acid-binding protein (h-fabp) in patients with acute chest pain and compare it with standard cardiac markers.methodswe 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 kinase-mb (ck-mb) mass, myoglobin, and h-fabp were determined at presentation and 2, 4, 8–10, and 16–24 hours after presentation. the main outcome measure was the best sensitivity value within 6 hours after symptom onset.resultsh-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 identified at presentation and 2 hours after presentation respectively. the sensitivity of all other cardiac markers (ck-mb mass, ctni, ctnt, and myoglobin) at presentation was < 62%. the negative predictive value of h-fabp (94%) was also superior to other markers within the first 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.conclusioncombined measurement of h-fabp and ctni on two occasions during the first 8 hours after symptom onset was sufficiently sensitive and specific for the early diagnosis of most patients with acute mi and may provide advantages over other cardiac marker combinations