title: Prognostic value of serum concentration of heart-type fatty acid-binding protein relative to cardiac troponin T on admission in the early hours of acute coronary syndrome.
abstract: BACKGROUND
  Heart-type fatty acid-binding protein (H-FABP) is proposed as an early biomarker for acute myocardial infarction (AMI), but its prognostic value is unclear in acute coronary syndrome (ACS). We evaluated the prognostic value of the H-FABP concentration relative to cardiac troponin T (cTnT) in the early hours of ACS.
  
  
  METHODS
  Serum concentrations of H-FABP and cTnT were measured on admission in 328 consecutive patients hospitalized for ACS within 6 h after the onset of chest pain [AMI, 241 (73.5%) patients; ST-segment elevation myocardial infarction, 154 (47.0%) patients; and emergent coronary angiography within 24 h after admission, 287 (87.5%) patients]. Cardiac events, which were defined as cardiac death or subsequent nonfatal AMI, were monitored for 6 months after admission.
  
  
  RESULTS
  During the 6-month follow-up period, there were 25 cardiac events, including 15 cardiac deaths and 10 subsequent nonfatal AMIs. Stepwise multivariate analyses including clinical, electrocardiographic, and biochemical variables revealed that increased H-FABP (above the median of 9.8 microg/L), but not increased cTnT (above the median of 0.02 microg/L), was independently associated with cardiac events in all patients [relative risk (RR) = 8.96; P = 0.0004], the subgroup of patients with ST-segment elevation myocardial infarction (RR = 11.3; P = 0.02), and the subgroup of patients with unstable angina and non-ST-segment elevation myocardial infarction (RR = 8.31; P = 0.007). The area under the ROC curve was higher for H-FABP than for cTnT (0.711 vs 0.578; P = 0.08), suggesting that H-FABP concentrations have a greater predictive capacity for cardiac events than cTnT.
  
  
  CONCLUSIONS
  Serum H-FABP is a potential independent predictor of cardiac events within 6 months of patient admission and may provide prognostic information superior to cTnT in the early hours of ACS.
authors.affiliation: Division of Critical Care, Fujita Health University Graduate School of Health Sciences, Toyoake, Japan. jishii@fujita-hu.ac.jp
authors.forename: Junnichi
authors.initials: J
authors.lastname: Ishii
authors.forename: Yukio
authors.initials: Y
authors.lastname: Ozaki
authors.forename: Jingchao
authors.initials: J
authors.lastname: Lu
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Kitagawa
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kuno
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nakano
authors.forename: Yuu
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Naruse
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Mori
authors.forename: Shigeru
authors.initials: S
authors.lastname: Matsui
authors.forename: Hisaji
authors.initials: H
authors.lastname: Oshima
authors.forename: Masanori
authors.initials: M
authors.lastname: Nomura
authors.forename: Kouji
authors.initials: K
authors.lastname: Ezaki
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hishida
mesh_terms: D000208:Acute Disease; D015415:Biomarkers / Q000097:blood; D002352:Carrier Proteins / Q000097:blood*; D002637:Chest Pain / Q000175:diagnosis; D003643:Death; D050556:Fatty Acid-Binding Proteins; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000175:diagnosis* / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology; D009206:Myocardium / Q000378:metabolism*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012306:Risk; D013997:Time Factors; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D002352:Carrier Proteins; D050556:Fatty Acid-Binding Proteins; D020107:Troponin T