Serum concentrations of myoglobin vs human heart-type cytoplasmic fatty acid-binding protein in early detection of acute myocardial infarction.
We compared the diagnostic utility of serum concentrations of human heart-type cytoplasmic fatty acid-binding protein (H-FABPc), myoglobin, and their ratio for the early diagnosis of acute myocardial infarction (AMI) in 104 healthy volunteers and 165 patients at admission within 6 h of the onset of chest pain. The ROC curves of the H-FABPc [0.946, 95% confidence interval (CI) = 0.913-0.979] and myoglobin (0.895, 95% CI = 0.846-0.944) between patients with AMI and healthy volunteers were significantly greater than the area under the ratio of myoglobin to H-FABPc (0.823, 95% CI = 0.765-0.881). In 165 patients, the sensitivity (81.8%, 95% CI = 74.2-89.4%), specificity (86.4%, 95% CI = 78.1-94.6%), and predictive accuracy (83.6%, 95% CI = 78.0-89.3%) of H-FABPc > 12 micrograms/L in diagnosing AMI were significantly higher than those of myoglobin, and were similar to those of the combination of H-FABPc > 12 micrograms/L and the ratio < or = 14. We conclude that H-FABPc is a more sensitive and specific marker than myoglobin for the early diagnosis of AMI, and that their ratio cannot give a clear advantage over the measurement of H-FABPc alone.
Ishii
J
J
Department of Internal Medicine, Fujita Health University School of Medicine, Aichi, Japan.
Wang
J H
JH
Naruse
H
H
Taga
S
S
Kinoshita
M
M
Kurokawa
H
H
Iwase
M
M
Kondo
T
T
Nomura
M
M
Nagamura
Y
Y
Watanabe
Y
Y
Hishida
H
H
Tanaka
T
T
Kawamura
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris; D015415:Biomarkers / Q000097:blood; D002352:Carrier Proteins / Q000097:blood*; D000071438:Fatty Acid-Binding Protein 7; D050556:Fatty Acid-Binding Proteins; D005227:Fatty Acids; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D018996:Myelin P2 Protein / Q000097:blood*; D009203:Myocardial Infarction / Q000175:diagnosis*; D009206:Myocardium / Q000737:chemistry*; D009211:Myoglobin / Q000097:blood*; D009363:Neoplasm Proteins; D011237:Predictive Value of Tests; D012372:ROC Curve; D025521:Tumor Suppressor Proteins
D015415:Biomarkers; D002352:Carrier Proteins; C107608:FABP7 protein, human; D000071438:Fatty Acid-Binding Protein 7; D050556:Fatty Acid-Binding Proteins; D005227:Fatty Acids; D018996:Myelin P2 Protein; D009211:Myoglobin; D009363:Neoplasm Proteins; D025521:Tumor Suppressor Proteins