A Study on the Role of Heart Type Fatty Acid Binding Protein in the Diagnosis
of Acute Myocardial Infarction
Published: January 1, 2016 | DOI: https://doi.org/10.7860/JCDR/2016/.7057
Shama Prakash Kabekkodu, Sudhindra Rao Mananje, Rama Prakasha Saya
1. Associate Professor, Department of General Medicine, KS Hegde Medical Academy, Deralakatte, Mangaluru, India.
2. Associate Professor, Department of General Medicine, KS Hegde Medical Academy, Deralakatte, Mangaluru, India.
3. Assistant Professor, Department of EM and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Correspondence
Dr. Rama Prakasha Saya,
Assistant Professor, Department of EM and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research,
Puducherry, India.
E-mail: dr_prakashbhat@yahoo.co.in
Introduction: Heart type Fatty Acid Binding Protein (H-FABP) has been proposed as an early cardiac biomarker for the diagnosis of acute myocardial Infarction (AMI) using animal models and clinical samples.
Aim: The study aimed to evaluate the role of H-FABP in early detection of AMI by comparing its sensitivity, specificity and predictive value with Creatinine Kinase-MB (CK-MB) and Cardiac Troponin I (cTnI).
Materials and Methods: This is a cross-sectional descriptive study of 50 patients admitted with the diagnosis of AMI at a tertiary care hospital in South India. The study group was categorised in to those coming to the hospital within four hours of symptom onset and those coming in between 4 to 12 hours. H-FABP was compared with those of troponin T and myoglobin tests.
Results: Among patients presenting within four hours of symptom onset, the sensitivity of H-FABP was 60% and was significantly higher than that of cardiac Troponin I (cTnI, 18.8%) and Creatinine Kinase (CK)-MB (12.5%). But specificity was only 23.53% and was less than that of cTnI (66.67%) and CK-MB (100%). In patients presenting during 4 to 12 hours of symptom onset, the sensitivity of H-FABP was 86.96% which was comparable to that of cTnI (90.9%) and CK-MB (77.3%). The specificity was 60% in the 4-12 hours group which was comparable to that of cTnI (50%) and CK-MB (50%).
Conclusion: The H-FABP is a sensitive biomarker for the diagnosis of AMI in the initial hours after symptom onset when the standard biomarkers may not be elevated, but it is less specific. During 4-12 hours of symptom onset it is as sensitive and specific as standard cardiac biomarkers troponin and CK-MB. Due to these factors H-FABP can be considered as a promising cardiac biomarker which can be used along with troponins and CK-MB at present.
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