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Serum 99th centile values for two heart-type fatty acid binding protein assays
D P Bathia1, D R Carless, K Viswanathan
1Department of Clinical Biochemistry, Leeds General Infirmary, UK.
Insights
Heart-type fatty acid binding protein (H-FABP) levels increase with age and renal dysfunction. Defined 99th centile values for H-FABP assays aid in risk stratification for acute coronary syndrome (ACS) patients.
Area of Science:
- Cardiology
- Biomarker Research
- Clinical Chemistry
Background:
- Heart-type fatty acid binding protein (H-FABP) is a prognostic marker for acute coronary syndrome (ACS) survival.
- Previous studies indicated H-FABP's prognostic value, necessitating further investigation into assay-specific centile values and influencing factors.
Purpose of the Study:
- To define the 99th centile values for H-FABP using two distinct assays.
- To investigate the relationship between H-FABP levels, age, gender, and renal function.
Main Methods:
- H-FABP was measured using MARKIT-M (Dainippon) and Evidence Investigator (Randox) assays on routine outpatient samples.
- Subjects with Siemens Ultra-TnI <0.045 microg/L were included, with subgroup analysis based on estimated glomerular filtration rate (eGFR).
Main Results:
- The 99th centile values for H-FABP varied between assays and genders (e.g., Evidence Investigator: 5.3-5.8 microg/L; MARKIT-M: 8.3-9.1 microg/L for normal renal function).
- H-FABP levels increased with age and were significantly higher in subjects with impaired renal function (eGFR <60 mL/min) compared to those with normal function.
- No significant gender difference in H-FABP levels was observed for either assay.
Conclusions:
- Established 99th centile values for H-FABP provide a reference for risk stratification in ACS patients.
- H-FABP levels are influenced by age and renal function, with increased levels observed in cases of renal dysfunction.
- The study did not confirm a previously reported gender difference in H-FABP levels.
Background:
We have previously demonstrated that heart-type fatty acid binding protein (H-FABP) is an independent prognostic marker for survival after acute coronary syndrome (ACS). This study aimed to define the 99th centile values for H-FABP as determined with two different assays, and to study the relationship with age, gender and renal function.
Methods:
H-FABP was measured on redundant routine outpatient samples using the MARKIT-M (Dainippon) and the Evidence Investigator (Randox) assays.
Results:
Two hundred and forty-two subjects with Siemens Ultra-TnI value <0.045 microg/L (99th centile) were studied. In all, 174 subjects had estimated glomerular filtration rate (eGFR) >60 mL/min. The 99th centile values for subjects with eGFR >60 mL/min for the Evidence Investigator H-FABP were 5.3 and 5.8 microg/L and for the MARKIT-M H-FABP were 8.3 and 9.1 microg/L in female and male subjects, respectively. There is an increase in H-FABP with age in subjects with normal renal function for both assays. Gender comparison showed no significant difference for either assay. Comparison of samples showed that subjects with eGFR <60 mL/min showed a median increase of 0.71 microg/L with Evidence Investigator assay and 1.09 microg/L with MARKIT-M assay compared with subjects with eGFR >60 mL/min. Calibration differences were confirmed by cross measurement of calibrators and recombinant H-FABP.
Conclusions:
We have defined the 99th centile values for H-FABP in a population of primary and secondary care outpatients that can be used to risk stratify patients with ACS. We have confirmed that H-FABP increases with renal dysfunction and age, but have not confirmed the gender difference previously reported.
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