Comparative study of high sensitivity troponin T and heart-type fatty acid-binding protein in STEMI patients
Shaheena Banu1, Syed Tanveer2, C N Manjunath2
1Department of Biochemistry, Sri Jayadeva Institute of Cardiovascular Sciences and Research, India.
Insights
High-sensitivity troponin T (hs-Trop T) is more sensitive than heart-type fatty acid-binding proteins (H-FABP) for early detection of ST-elevation myocardial infarction (STEMI). Higher hs-Trop T levels also predict increased in-hospital mortality in STEMI patients.
Area of Science:
- Cardiology
- Biomarker Research
- Emergency Medicine
Background:
- Heart-type fatty acid-binding proteins (H-FABP) are involved in fatty acid uptake in the myocardium and are detected early in acute myocardial infarction.
- Early diagnosis of acute myocardial infarction (AMI) is crucial for timely intervention and improved patient outcomes.
Purpose of the Study:
- To compare the diagnostic window periods of H-FABP and high-sensitivity troponin T (hs-Trop T) in patients with acute ST-elevation myocardial infarction (STEMI).
- To evaluate the correlation of these biomarkers with clinical outcomes such as in-hospital mortality.
Main Methods:
- Serum samples from 160 STEMI patients were analyzed for hs-Trop T and H-FABP levels.
- Patients were categorized based on the time of chest pain onset (<3 hours, 3-6 hours, >6 hours) and analyzed for biomarker sensitivity, complications, and mortality.
Main Results:
- Hs-Trop T demonstrated higher sensitivity (92-97%) across different time windows compared to H-FABP (75-88%).
- Hs-Trop T levels showed a statistically significant correlation with age, window period, TIMI score, ejection fraction, H-FABP, and hs-CRP.
- Higher hs-Trop T levels were significantly associated with increased in-hospital mortality (0.35 vs. 0.85 ng/ml, p=0.008).
Conclusions:
- Hs-Trop T is a more sensitive biomarker than H-FABP for the early detection of AMI, particularly within the first 6 hours.
- Elevated hs-Trop T levels are predictive of increased in-hospital mortality in STEMI patients, highlighting its prognostic value.
Aim And Background:
Heart-type fatty acid-binding proteins (H-FABP) which are detected within 2-3 h of acute myocardial infarction are involved in uptake of free fatty acids in the myocardium. Our aim in the present study is to compare window periods of H-FABP to high sensitivity troponin T (hs-Trop T) in acute ST elevation myocardial infarction (STEMI).
Methods:
160 STEMI diagnosed patient's serum samples are analyzed for hs-Trop T and H-FABP. Different window periods of chest pain onset (<3 h, 3-6 h and >6 h) are compared with complications, in-hospital mortality and statistically analyzed.
Results:
From 160 patients, 53 (33%) cases are presented in <3 h, 75 (47%) in 3-6, and 32 (20%) after >6 h respectively. Accordingly sensitivity of hs-Trop T was 92%, 94% and 97% while H-FABP was 75%, 88% and 84%, respectively. Overall sensitivity was 94% and 82% respectively. Statistically significant difference between mean hs-Trop T values with respect to window period <3, 3-6 and >6 h was 0.21, 0.35 and 0.80 ng/ml respectively, p value < 0.0001. No significant difference in H-FABP values was observed. Hs-Trop T positively correlated with age (r = 0.153, P = 0.05), window period (r = 0.363, P < 0.0001), TIMI score (r = 0.208, P = 0.008), ejection fraction (r = 0.191, P = 0.008), serum H-FABP (r = 0.229, P = 0.004), and serum hs-CRP (r = 0.326, p < 0.001). There was a statistically significant difference of mean hs-Trop T values with or without in hospital mortality (0.35 vs. 0.85 ng/ml, respectively, p = 0.008). No significant correlation to age, TIMI score, ejection fraction and hs-CRP values for H-FABP was observed.
Conclusion:
It appears that hs-Trop T is a more sensitive marker than H-FABP in early hours of AMI and higher hs-Trop T predicts increase in-hospital mortality.
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