title: Human heart-type fatty-acid-binding protein as a point-of-care test in the early diagnosis of acute myocardial infarction.
abstract: 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.
authors.affiliation: Department of Emergency Medicine, Medical University Vienna, General Hospital, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
authors.forename: P
authors.initials: P
authors.lastname: Mad
authors.forename: H
authors.initials: H
authors.lastname: Domanovits
authors.forename: C
authors.initials: C
authors.lastname: Fazelnia
authors.forename: K
authors.initials: K
authors.lastname: Stiassny
authors.forename: G
authors.initials: G
authors.lastname: Russmüller
authors.forename: A
authors.initials: A
authors.lastname: Cseh
authors.forename: G
authors.initials: G
authors.lastname: Sodeck
authors.forename: T
authors.initials: T
authors.lastname: Binder
authors.forename: G
authors.initials: G
authors.lastname: Christ
authors.forename: T
authors.initials: T
authors.lastname: Szekeres
authors.forename: A
authors.initials: A
authors.lastname: Laggner
authors.forename: H
authors.initials: H
authors.lastname: Herkner
mesh_terms: 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
chemical_list: C493408:FABP3 protein, human; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins