title: Comparison of heart-type fatty acid binding protein and sensitive troponin for the diagnosis of early acute myocardial infarction.
abstract: BACKGROUND
  The current development of serological biomarkers allows detection of smaller myocardial necrosis and early acute myocardial infarction (AMI). We evaluated the relevance of the heart-type fatty acid binding protein (H-FABP) assay, which has recently been approved in Japan, for early diagnosis of AMI as compared with the sensitive troponin assay.
  
  
  METHODS
  This is an observational study in a single center. From 2010 July to 2011 January, 114 patients who presented with symptoms suggestive of AMI were enrolled.
  
  
  RESULTS
  AMI was adjudicated in 45 patients (40%). The diagnostic accuracy of measurements obtained at presentation for AMI, as quantified by the area under the receiver-operating-characteristic curve (AUC), was significantly lower with H-FABP assay than the sensitive troponin assay [AUC for H-FABP, 0.59; 95% confidence interval (CI) 0.48-0.70; and for troponin I, 0.89; 95% CI, 0.83-0.94; P<.0001]. Among patients who presented within 2h after the onset of chest pain, the AUC for H-FABP was even low as compared with sensitive troponin (0.55; 0.39-0.72 vs. 0.89; 0.80-0.98, p<0.001). The clinical sensitivity for the diagnosis of AMI with the cutoff point of 99 th percentile was similar in both assays (81% and 81%, respectively), however, the specificity was extremely low in the H-FABP assay as compared with sensitive troponin assay (19% and 79%, respectively).
  
  
  CONCLUSIONS
  The measurement of H-FABP in 114 consecutive patients with chest pain suggestive of AMI showed no improvement of diagnosis for early AMI as compared with the current sensitive troponin assay because of its extremely low specificity.
authors.affiliation: Division of Cardiology, Tsuchiya General Hospital, Japan.
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Kagawa
authors.forename: Mamoru
authors.initials: M
authors.lastname: Toyofuku
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Masaoka
authors.forename: Yuji
authors.initials: Y
authors.lastname: Muraoka
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Okimoto
authors.forename: Masaya
authors.initials: M
authors.lastname: Otsuka
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Tamekiyo
authors.forename: Shinji
authors.initials: S
authors.lastname: Mito
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Kawase
authors.forename: Kenichi
authors.initials: K
authors.lastname: Yamane
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Senoo
authors.forename: Michitaka
authors.initials: M
authors.lastname: Amioka
authors.forename: Nobuo
authors.initials: N
authors.lastname: Shiode
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Hayashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; 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 / Q000097:blood* / Q000175:diagnosis*; D012042:Registries; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; C493408:FABP3 protein, human; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins; D020107:Troponin T