Elevated heart-type fatty acid-binding protein predicts early myocardial injury and aids in the diagnosis of non-ST elevation myocardial infarction

Background: Biomarkers play an important role in the early diagnosis, risk stratification and management of patients with the acute coronary syndrome. Objective: The objective of this study was to evaluate the clinical reliability of heart-type fatty acid-binding protein (h-FABP) in identifying patients with the acute coronary syndrome in the early hours of chest pain. Methods: Creatine kinase (CK-MB) (in laboratory), troponin T (in laboratory) and h-FABP (with point-of-care test CardioDetect (R)) were performed on 791 patients who presented with chest pain with duration since onset ranging from 20 minutes to 12 hours. Results: Data of the 791 patients were analysed. h-FABP had a higher sensitivity of 75.76% and a specificity of 96.97% compared with 58.59% and 98.84% for troponin T and 68.69% and 97.54% for CK-MB respectively (in the first 6 hours). Conclusion: h-FABP was found to be a better biomarker of cardiac necrosis in the early hours in the diagnosis of non-conclusive ECG in patients with acute myocardial infarction. (Hong Kong j.emerg.med. 2009;16:141-147)