Heart-type Fatty Acid Binding Protein as an Adjunct to Cardiac Troponin-I for the Diagnosis of Myocardial Infarction.
10.3346/jkms.2011.26.1.47
- Author:
Kyung Su KIM
1
;
Hui Jai LEE
;
Kyuseok KIM
;
You Hwan JO
;
Tae Yun KIM
;
Jin Hee LEE
;
Joong Eui RHEE
;
Gil Joon SUH
;
Mi Ran KIM
;
Christopher C LEE
;
Adam J SINGER
Author Information
1. Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Myocardial Infarction;
Fatty Acid-Binding Proteins;
Point-of-Care Systems;
Chest Pain
- MeSH:
Aged;
Area Under Curve;
Biological Markers/blood;
Chest Pain/complications;
Creatine Kinase, MB Form/blood;
Early Diagnosis;
Fatty Acid-Binding Proteins/*blood;
Female;
Humans;
Logistic Models;
Male;
Middle Aged;
Myocardial Infarction/complications/*diagnosis;
Myoglobin/blood;
Point-of-Care Systems;
Predictive Value of Tests;
Troponin I/*blood
- From:Journal of Korean Medical Science
2011;26(1):47-52
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
