Heart-type Fatty Acid Binding Protein as an Adjunct to Cardiac Troponin-I for the Diagnosis of Myocardial Infarction

• Published in: Journal of Korean medical science Vol. 26; no. 1; pp. 47 - 52
• Main Authors: Kim, Kyung Su, Lee, Hui Jai, Kim, Kyuseok, Jo, You Hwan, Kim, Tae Yun, Lee, Jin Hee, Rhee, Joong Eui, Suh, Gil Joon, Kim, Mi Ran, Lee, Christopher C., Singer, Adam J.
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.01.2011; 대한의학회
• Subjects: Aged; Area Under Curve; Biomarkers - blood; Chest Pain - complications; Creatine Kinase, MB Form - blood; Early Diagnosis; Fatty Acid Binding Protein 3; Fatty Acid-Binding Proteins - blood; Female; Humans; Logistic Models; Male; Middle Aged; Myocardial Infarction - complications; Myocardial Infarction - diagnosis; Myoglobin - blood; Original; Point-of-Care Systems; Predictive Value of Tests; Troponin I - blood; 의학일반; Fatty Acid-Binding Proteins; Myocardial Infarction; Point-of-Care Systems; Chest Pain
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2011.26.1.47

We hypothesized that when used in combination with cardiac troponins, heart-type fatty acid binding protein (H-FABP) would have greater diagnostic value than conventional markers for the early diagnosis of myocardial infarction (MI). Patients with typical chest pain at a single emergency department were consecutively enrolled. Initial blood samples were drawn for H-FABP, myoglobin, creatine kinase isoenzyme MB (CK-MB), and cardiac troponin-I (cTnI) measurements. MI was defined by serial cTnI measurements. To evaluate the adjunctive role of biochemical markers, we derived and compared logistic regression models predicting MI in terms of their discrimination (area under the receiver operating characteristics curve, AUC) and overall fit (Bayesian information criterion, BIC). Seventy-six of 170 patients were diagnosed as having MI. The AUC of cTnI, H-FABP, myoglobin, and CK-MB were 0.863, 0.827, 0.784, and 0.772, respectively. A logistic regression model using cTnI (P = 0.001) and H-FABP (P < 0.001) had the biggest AUC (0.900) and the best fit determined by BIC. Sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of this model at 30% probability were 81.6%, 80.9%, 4.26, and 0.23, respectively. H-FABP has a better diagnostic value than both myoglobin and CK-MB as an adjunct to cTnI for the early diagnosis of MI.