title: Heart-Type Fatty Acid-Binding Protein in the Early Diagnosis of Acute Myocardial Infarction: The potential for influencing patient management.
abstract: OBJECTIVE
  The objective of this study was to evaluate the diagnostic value of heart-type fatty acid-binding protein (H-FABP) in patients with acute chest pain and compare it with standard cardiac markers.
  
  
  METHODS
  We undertook a prospective evaluation of 100 consecutive patients admitted with acute chest pain suggestive of acute coronary syndromes (ACS). Serum cardiac troponin I (cTnI), cardiac troponin T (cTnT), creatine kinase-MB (CK-MB) mass, myoglobin, and H-FABP were determined at presentation and 2, 4, 8-10, and 16-24 hours after presentation. The main outcome measure was the best sensitivity value within 6 hours after symptom onset.
  
  
  RESULTS
  H-FABP peak concentration occurred at 8 hours after symptoms onset and was the most sensitive early marker with 79.9% and 98% of patients with AMI identified at presentation and 2 hours after presentation respectively. The sensitivity of all other cardiac markers (CK-MB mass, cTnI, cTnT, and myoglobin) at presentation was < 62%. The negative predictive value of H-FABP (94%) was also superior to other markers within the first 2 hours of presentation. Myoglobin was the second most sensitive early marker at presentation. Peak sensitivity of cTnI, CK-MB mass, and cTnT were present at 4, 8-10, and 8-10 hours respectively after presentation.
  
  
  CONCLUSIONS
  Combined measurement of H-FABP and cTnI on two occasions during the first 8 hours after symptom onset was sufficiently sensitive and specific for the early diagnosis of most patients with acute MI and may provide advantages over other cardiac marker combinations.
authors.affiliation: Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman.
authors.forename: Hafidh A
authors.initials: HA
authors.lastname: Alhadi
authors.forename: Keith A A
authors.initials: KA
authors.lastname: Fox