Office cardiologists cooperative study on whole blood rapid panel tests in patients with suspicious acute myocardial infarction: comparison between heart-type fatty acid-binding protein and troponin T tests.
BACKGROUND
The whole blood rapid troponin T test, used to determine the early diagnosis of acute myocardial infarction (AMI), is effective only for 3-4 h after onset.


RESULTS
The present office cardiologists cooperative study compared the diagnostic efficacy of a newly developed whole blood rapid panel test for heart-type fatty acid-binding protein (H-FABP) with that of the rapid troponin T test in 129 consecutive patients with suspicious AMI according to certain time-frames from onset to presentation. Thirty-one patients (24.0%) had a final diagnosis of AMI. The respective sensitivities of the rapid H-FABP and troponin T tests were 100% vs 50% (p<0.05) for patients presenting within 3 h of onset; 75% vs 0% for those between 3 and 6 h; 100% vs 60% for those between 6 and 12 h; and 100% vs 100% for those presenting later than 12 h. The respective specificities were 63% vs 96.3% (p<0.05); 93.8% vs 93.8%; 72.7% vs 100%; and 75.0% vs 87.5%. Negative predictive value was 100% vs 86.7%; 93.8% vs 78.9%; 100% vs 84.6%; and 100% vs 100%, respectively. Patients with non-AMI myocardial damage associated with unstable angina or severe heart failure showed positive H-FABP test results and blunted the specificity.


CONCLUSIONS
When using the novel rapid H-FABP test, cardiac emergency triage to exclude non-AMI patients should be effectively organized within 3 h of onset.
Seino
Yoshihiko
Y
Office of Tokyo ROC Study, The First Department of Internal Medicine, Nippon Medical School, Japan. y-seino@mms.ac.jp
Tomita
Yoshifumi
Y
Takano
Teruo
T
Ohbayashi
Kanji
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001774:Blood Chemical Analysis; D002309:Cardiology; D002352:Carrier Proteins / Q000097:blood*; D003951:Diagnostic Errors; D050556:Fatty Acid-Binding Proteins; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis*; D009819:Office Visits; D012680:Sensitivity and Specificity; D013997:Time Factors; D014218:Triage / Q000379:methods; D020107:Troponin T / Q000097:blood*
D002352:Carrier Proteins; D050556:Fatty Acid-Binding Proteins; D020107:Troponin T