title: Diagnostic and prognostic value of heart-type fatty acid-binding protein in the early hours of acute myocardial infarction.
abstract: BACKGROUND
  Heart-type fatty acid-binding protein (H-FABP) is a cytosolic protein that is released into the bloodstream when the myocardium is injured. The aim was to determine the diagnostic and prognostic value of H-FABP in patients with suspected acute myocardial infarction (AMI) within the first 3-6 hours after the onset of chest pain.
  
  
  RESULTS
  A consecutive series of 165 patients with chest pain lasting less than 6 hours were enrolled in a forward observational design in the emergency department.The diagnostic validity of H-FABP was evaluated according to sensitivity, specificity, and predictive values, likelihood ratios, ROC curves, and multivariate logistic regression analyses. The prognostic value of H-FABP at 6 months was checked using survival curves and the multivariate Cox proportional hazards model. The sensitivity of H-FABP was 81% (95% CI: 69.2-92.9). Its area under the ROC curve: 0.729 (95% CI: 0.63-0.83) and negative likelihood ratio (0.38; 95% CI: 0.22-0.65) were significantly better than both troponin (cTnI) and CK-MB, whereas its specificity, 53% (95% CI: 41.1-64.8), was lower than that of the other markers. Increased H-FABP added diagnostic information as it demonstrated independent association with AMI by logistic regression analysis. Increased H-FABP and cTnI were both strong and independent predictors of outcome in the 6-month follow-up (hazard ratio: 2.18; 95% CI: 1.07-4.42; and 2.34; 95% CI: 0.98-5.59, respectively).
  
  
  CONCLUSIONS
  H-FABP is, within 6 hours and also within 3 hours, more sensitive than the other markers in the early diagnosis of AMI and it is an independent prediction factor of events within 6 months.
authors: Department of Clinical Chemistry, BR Salud, Infanta Sofía Hospital, Madrid, Spain. sgarcia-valdecasas@brsalud.es
authors: Sonsoles
authors: S
authors: Garcia-Valdecasas
authors: Maria J
authors: MJ
authors: Ruiz-Alvarez
authors: Jaime
authors: J
authors: Garcia De Tena
authors: Raul
authors: R
authors: De Pablo
authors: Isabel
authors: I
authors: Huerta
authors: Marta
authors: M
authors: Barrionuevo
authors: Carmen
authors: C
authors: Coca
authors: Ignacio
authors: I
authors: Arribas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; 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*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D019210:Troponin I / Q000097:blood
chemical_list: C493408:FABP3 protein, human; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins; D019210:Troponin I