title: Heart fatty acid-binding protein offers similar diagnostic performance to high-sensitivity troponin T in emergency room patients presenting with chest pain.
abstract: BACKGROUND
  The aim of the present study was to evaluate the diagnostic accuracy of high-sensitivity troponin T (hsTnT) in patients with suspected acute coronary syndrome (ACS) in comparison to heart fatty acid-binding protein (H-FABP), high-sensitivity C-reactive protein, myeloperoxidase (MPO), and pentraxin 3 (PTX3).
  
  
  RESULTS
  Patients (n=432) with chest pain were recruited for the analysis. ACS was diagnosed in 298 patients (69%). The diagnostic accuracy of measurements obtained at presentation, as quantified by the area under the receiver operating curve (AUC), was highest for hsTnT (AUC=0.82; 95% confidence interval [CI]: 0.78-0.87) and H-FABP (AUC=0.83; 95%CI: 0.78-0.87). Sensitivity (87.9%) and negative likelihood (LH; 0.2) for hsTnT were the highest and lowest, respectively, but H-FABP had the highest specificity (78.5%) and positive LH (3.6). Among patients who presented within 2h after the onset of chest pain, MPO had the highest AUC (0.82; 95%CI: 0.69-0.94). Combined use of H-FABP and MPO measurements yielded a sensitivity of 69.2%, specificity of 84.2%, positive LH of 4.4, and negative LH of 0.4.
  
  
  CONCLUSIONS
  The hsTnT assay offers excellent diagnostic performance to rule out ACS, but it is prone to false-positive results. H-FABP offers similar overall diagnostic performance, while the combination of H-FABP and MPO assays may improve the diagnosis of ACS, particularly in patients with recent onset of chest pain.
authors.affiliation: Department of Cardiology, Juntendo University Nerima Hospital, Tokyo, Japan. inouelsbm@yahoo.co.jp
authors.forename: Kenji
authors.initials: K
authors.lastname: Inoue
authors.forename: Satoru
authors.initials: S
authors.lastname: Suwa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohta
authors.forename: Seigo
authors.initials: S
authors.lastname: Itoh
authors.forename: Sonomi
authors.initials: S
authors.lastname: Maruyama
authors.forename: Nobuhito
authors.initials: N
authors.lastname: Masuda
authors.forename: Manabu
authors.initials: M
authors.lastname: Sugita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000175:diagnosis*; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D002637:Chest Pain / Q000097:blood* / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D004632:Emergency Medical Services / Q000379:methods*; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009195:Peroxidase / Q000097:blood; D000683:Serum Amyloid P-Component / Q000378:metabolism; D020107:Troponin T / Q000097:blood*; D000099153:Pentraxins
chemical_list: D002097:C-Reactive Protein; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins; D009195:Peroxidase; D000683:Serum Amyloid P-Component; D020107:Troponin T; D000099153:Pentraxins; C493408:FABP3 protein, human