Cardiac multi-marker strategy for effective diagnosis of acute myocardial infarction.
BACKGROUND
Heart-type fatty acid-binding protein (H-FABP) is a heart-specific and highly sensitive biomarker for early diagnosis of acute myocardial infarction (AMI). We investigated the effectiveness of H-FABP for diagnosis of AMI in patients with different ethnic background and different time from symptom onset.


METHODS
Venous blood was withdrawn from consecutive patients with acute chest pain admitted to the First Affiliated Hospital of Xinjiang Medical University. The blood samples were used for measurement of creatine kinase MB (CK-MB) and cardiac troponin I (cTnI) using Beckman Coulter DC-800 analyzer, and detection of H-FABP using a one-step bedside immunotest.


RESULTS
Two hundred and eighty-nine patients admitted within 12h after the onset of symptoms were recruited in the study. The H-FABP immunotest was found to have higher diagnostic accuracy than cTnI and CK-MB in patients admitted within 3h. The combination of H-FABP and cTnI was found to have the highest diagnostic accuracy (91%) among different cardiac markers and the other combinations. It gave the highest sensitivity [96% (95% CI: 91-98%)] and a comparable specificity [84% (95% CI: 76-89%)] to cTnI alone.


CONCLUSIONS
A cardiac panel consisting of H-FABP and troponin is recommended.
Xu
Qin
Q
The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Chan
Cangel P Y
CP
Cao
Xiao-yao
XY
Peng
Peng
P
Mahemuti
Maisumu
M
Sun
Qi
Q
Cheung
Kwan-yee
KY
Ip
Wai-sze
WS
Zhou
Xin-rong
XR
Hu
Ge-yang
GY
Zhang
Xiao-feng
XF
Jielile
Jiasharete
J
Li
Yao-dong
YD
Ren
Rong
R
Glatz
Jan F C
JF
Renneberg
Reinhard
R
D000368:Aged; D015415:Biomarkers / Q000097:blood; D002637:Chest Pain / Q000209:etiology; D005006:Ethnicity; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000592:standards; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis* / Q000208:ethnology; D012680:Sensitivity and Specificity; D013997:Time Factors; D019210:Troponin I / Q000097:blood
D015415:Biomarkers; C493408:FABP3 protein, human; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins; D019210:Troponin I