The value of human heart-type fatty acid binding protein in diagnosis of patients with acute chest pain

Background: The aim was to determine the efficacy of heart-type fatty acid-binding protein (H-FABP) compared with routinely myoglobin (MYO), creatine kinase-MB (CK-MB) and cardiac troponin-I (cTn-I) in the early diagnosis of acute myocardial infarction (AMI) in patients presenting with acute chest pain. Methods and results: The patients were classified as AMI (n = 22), unstable angina (UA, n = 20) and non-cardiac chest pain (NCCP, n = 15) within 3 h and 6 h of acute chest pain according to the American College/European Society of Cardiology; and normal healthy subjects (controls, n = 10). Blood H-FABP levels were measured by ELISA and compared with cTn-I, CK-MB and MYO in all subjects. The diagnostic sensitivity, specificity and receiver operating characteristic (ROC) curve were evaluated. Serum H-FABP, MYO, CK-MB and cTn-I were significantly higher in AMI more than the UA, NCCP (non-AMI) and control groups within 6 h. However, Serum H-FABP, MYO and CK-MB were significantly elevated within 0-3 h and extend more within 3-6 h in AMI versus non-AMI. The cutoff value of H-FABP in AMI was 21.85 ng/ml within 3 h, and has diagnostic sensitivity (81.8%) equal to that of CK-MB and cTn-I but superior to that of MYO (72.7%). However, H-FABP has higher specificity (88.2%) equal to that of MYO but superior to that of CK-MB and cTn-I. This trend extends to within 6 h as well. Moreover, ROC curve areas for H-FABP were significantly higher (p < 0.05) than other biomarkers < 6 h after the onset of chest pain. Conclusion: H-FABP can be used as a sensitive biomarker for myocardial injury in early stage. (C) 2012 Egyptian Society of Cardiology. Production and hosting by Elsevier B. V. All rights reserved.