Heart-type fatty acid binding protein is a sensitive biomarker for early AMI detection in troponin negative patients:
Luisa Agnello1, Giulia Bivona1, Giuseppina Novo2
1a Sezione Biochimica Clinica e Medicina Molecolare, Dipartimento di Biopatologia e Biotecnologie Mediche , Università degli studi di Palermo , Palermo , Italy.
Insights
Human heart-type fatty acid-binding protein (h-FABP) may aid in early acute myocardial infarction (AMI) detection in emergency departments. This biomarker shows promise for ruling AMI in or out when cardiac troponin is initially negative.
Area of Science:
- Cardiology
- Biomarker Discovery
- Emergency Medicine
Background:
- Early detection of acute myocardial infarction (AMI) in emergency departments (ED) remains challenging.
- Standard cardiac troponin (cTn) tests can be negative in early presenters (<1 hour from symptom onset).
- Investigating novel biomarkers like h-FABP alongside high-sensitivity troponin (hs-TnI) is crucial for improving early diagnosis.
Purpose of the Study:
- To evaluate the diagnostic value of human heart-type fatty acid-binding protein (h-FABP) and high-sensitivity troponin I (hs-TnI) in patients presenting to the ED with chest pain and no initial cTnI elevation.
- To compare the sensitivity and specificity of h-FABP and hs-TnI in diagnosing AMI in this specific patient cohort.
Main Methods:
- A study included 28 AMI patients and 28 non-AMI individuals presenting to the ED within one hour of pain onset.
- h-FABP cut-off values were identified using blood donor data.
- Diagnostic accuracy was assessed using receiver operating characteristic (ROC) curves.
Main Results:
- Among AMI patients, 55% tested positive for h-FABP compared to 34.6% for hs-TnI (p=0.015).
- A significant 21% of AMI patients were positive only for h-FABP, indicating potential missed diagnoses with hs-TnI alone.
- h-FABP demonstrated higher sensitivity but lower specificity than hs-TnI.
Conclusions:
- h-FABP positivity was more frequent in AMI patients than hs-TnI in this study.
- hs-TnI alone would have missed six AMI cases identified by h-FABP.
- Preliminary findings suggest h-FABP is a potential candidate biomarker for AMI rule-in/rule-out in the ED setting.
Background:
Early detecting AMI in individuals presenting to the ED with chest pain continues to be a challenge. cTn is the gold standard for AMI diagnosis but early presenters (<1 hours from symptom onset) maybe cTn negative on admission. We analysed the diagnostic value of h-FABP and hs-TnI in patients presenting to ED with chest pain and no cTnI elevations.
Methods:
28 AMI and 28 no-AMI individuals both presented to ED within one hour from pain onset were included. Blood donors were analysed for h-FABP cut-off identification. Among AMI patients, 55% were positive for h-FABP and 34.6% were positive for hs-TnI (p = .015), thus 21% were positive only for h-FABP. The diagnostic accuracy was assessed by ROC curve. h-FABP showed a higher sensitivity but lower specificity than hs-TnI.
Conclusions:
In our study, the frequency of h-FABP positivity among AMI patients was higher than that of hs-TnI, which would have missed six of them; however, hs-TnI AUC was superior to that of h-FABP. These preliminary findings might confirm that h-FABP may be a good candidate for AMI rule-in/rule-out within the ED context.
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