Heart-type, fatty-acid binding protein can be a diagnostic marker in acute coronary syndromes.
OBJECTIVE
Chest pain is one of the most common complaints among patients admitted to emergency departments. Cardiac troponins, CK-MB and myoglobin, which are used routinely in the diagnosis of acute coronary syndrome (ACS), are not elevated in the initial hours of ACS--precluding their usefulness in the early diagnosis. The aim of this study is to determine the efficacy of H-FABP compared to myoglobin and CK-MB in the early diagnosis of ACS.


METHODS
Sixty-seven patients with ACS were enrolled in the study. An initial blood sample was obtained for CK-MB, cTnT, myoglobin and H-FABP. At the fourth, eighth, and 12th hours, repeat ECGs and cardiac enzyme samples were obtained. H-FABP test was repeated at the fourth hour.


RESULTS
H-FABP has sensitivity equal to that of CK-MB and superior to that of myoglobin (97.6%, 96.7%, 85.4%, respectively) on the first hour. This trend extends to the fourth hour of myocardial injury as well. H-FABP was more specific than CK-MB, myoglobin and troponin T at the first hour (38.5%, 34.6%, 34.6%, 23.1%, respectively), whereas its specificity at the fourth hour was equal to those of CK-MB and troponin T and exceeded that of myoglobin.


CONCLUSIONS
It can be suggested that in patients with an initial diagnosis of ACS and within 20 hours from symptom onset, H-FABP levels may be measured. For this purpose, point-of-care H-FABP test may be utilized, which has the advantage of bedside testing and rapid test results.
Cavus
Umut
U
Departments of Emergency Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Coskun
Figen
F
Yavuz
Bunyamin
B
Ciftci
Orcun
O
Sahiner
Levent
L
Aksoy
Hakan
H
Deniz
Ali
A
Ozakin
Engin
E
Aytemir
Kudret
K
Tokgozoglu
Lale
L
Kabakci
Giray
G
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D002637:Chest Pain; D003327:Coronary Disease / Q000097:blood* / Q000175:diagnosis*; D052279:Creatine Kinase, MB Form / Q000097:blood; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009211:Myoglobin / Q000097:blood; D019095:Point-of-Care Systems; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D014336:Troponin / Q000097:blood
D015415:Biomarkers; D050556:Fatty Acid-Binding Proteins; D009211:Myoglobin; D014336:Troponin; D052279:Creatine Kinase, MB Form