Use of a whole blood rapid panel test for heart-type fatty acid-binding protein in patients with acute chest pain: comparison with rapid troponin T and myoglobin tests.
OBJECTIVE
We sought to determine the clinical utility of a newly developed qualitative test to measure heart-type fatty acid-binding protein levels in blood for the early identification of myocardial infarction.


METHODS
We measured heart-type fatty acid-binding protein levels in 371 consecutive patients with acute chest pain and suspected myocardial infarction, and compared the performance of this test with those of troponin T and myoglobin tests. Levels of heart-type fatty acid-binding protein >or=6.2 ng/mL were considered as positive results.


RESULTS
A final diagnosis of acute myocardial infarction was made in 181 patients (49%). Of the 68 patients who presented within 2 hours of the onset of symptoms, 37 (54%) had a final diagnosis of myocardial infarction. The sensitivity of the rapid heart-type fatty acid-binding protein test was 89% (33/37), significantly higher than for troponin T (22% [8/37]; P<0.001) and myoglobin (38% [14/37]; P<0.001). However, the specificity of troponin T (94% [29/31]) was significantly better than for heart-type fatty acid-binding protein (52% [16/31]; P= 0.002) within 2 hours. The area under the receiver operating characteristic curve for heart-type fatty acid-binding protein levels was greater than that for myoglobin (0.72 vs. 0.61, P = 0.01) among patients who presented within 2 hours.


CONCLUSIONS
A novel whole blood rapid heart-type fatty acid-binding protein test can be useful in the early evaluation of patients who present with acute chest pain.
Seino
Yoshihiko
Y
First Department of Medicine and Coronary Care Unit, Nippon Medical School, Tokyo, Japan. y-seino@nms.ac.jp
Ogata
Ken-ichi
K
Takano
Teruo
T
Ishii
Jun-ichi
J
Hishida
Hitoshi
H
Morita
Hiroshi
H
Takeshita
Hitoshi
H
Takagi
Yasushi
Y
Sugiyama
Hiroshi
H
Tanaka
Takao
T
Kitaura
Yasushi
Y
D000208:Acute Disease; D015415:Biomarkers / Q000097:blood; D001774:Blood Chemical Analysis / Q000379:methods; D002352:Carrier Proteins / Q000097:blood*; D002637:Chest Pain / Q000097:blood* / Q000209:etiology; D000071438:Fatty Acid-Binding Protein 7; D050556:Fatty Acid-Binding Proteins; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D009211:Myoglobin / Q000097:blood*; D009363:Neoplasm Proteins; D012680:Sensitivity and Specificity; D020107:Troponin T / Q000097:blood*; D025521:Tumor Suppressor Proteins
D015415:Biomarkers; D002352:Carrier Proteins; C107608:FABP7 protein, human; D000071438:Fatty Acid-Binding Protein 7; D050556:Fatty Acid-Binding Proteins; D009211:Myoglobin; D009363:Neoplasm Proteins; D020107:Troponin T; D025521:Tumor Suppressor Proteins