Human heart-type fatty-acid-binding protein as a point-of-care test in the early diagnosis of acute myocardial infarction.
BACKGROUND
At very early stages of acute myocardial infarction (AMI), highly sensitive biomarkers are still lacking.


OBJECTIVE
To evaluate the utility of human heart-type fatty acid-binding protein (h-FABP) for early diagnosis of AMI.


METHODS
Prospective diagnostic study.


METHODS
Consecutive patients presenting to the emergency department with chest pain or dyspnoea within 24 h of symptom onset were included. At presentation, the h-FABP test result was compared to the standard diagnostic work-up, including repeated ECG and troponin T measurements. Sensitivity analysis was performed for inconclusive tests.


RESULTS
We enrolled 280 patients presenting to hospital with a median symptom onset of 3 h (IQR 2-6 h): 109 (39%) had AMI. At presentation, h-FABP had a sensitivity of 69% (95%CI 59-77) and specificity of 74% (95%CI 66-80); 45 tests were false-positive and 34 were false-negative. Omitting inconclusive tests increased sensitivity and specificity only slightly. AMI was identified significantly earlier by h-FABP than by troponin T (24 vs. 8 patients, p=0.005).


CONCLUSIONS
Although h-FABP can help to detect myocardial damage at an early stage in patients with chest pain or dyspnoea, it appears unsuitable as a stand-alone test for ruling out AMI.
Mad
P
P
Department of Emergency Medicine, Medical University Vienna, General Hospital, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
Domanovits
H
H
Fazelnia
C
C
Stiassny
K
K
Russmüller
G
G
Cseh
A
A
Sodeck
G
G
Binder
T
T
Christ
G
G
Szekeres
T
T
Laggner
A
A
Herkner
H
H
D042241:Early Diagnosis; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D019095:Point-of-Care Systems / Q000592:standards*; D011237:Predictive Value of Tests
C493408:FABP3 protein, human; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins