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. 2015 Oct;9(10):BC08-11.
doi: 10.7860/JCDR/2015/15132.6684. Epub 2015 Oct 1.

Heart-Type Fatty Acid Binding Protein: A Better Cardiac Biomarker than CK-MB and Myoglobin in the Early Diagnosis of Acute Myocardial Infarction

Anand K Pyati  1 , Basavaraj B Devaranavadagi  2 , Sanjeev L Sajjannar  3 , Shashikant V Nikam  4 , Mohd Shannawaz  5 , Sudharani  6
Affiliations

Heart-Type Fatty Acid Binding Protein: A Better Cardiac Biomarker than CK-MB and Myoglobin in the Early Diagnosis of Acute Myocardial Infarction

Anand K Pyati et al. J Clin Diagn Res. 2015 Oct.

Abstract

Background: Early diagnosis and therapeutic intervention can improve the outcome of acute myocardial infarction (AMI). However, there are no satisfactory cardiac biomarkers for the diagnosis of AMI within 6 hours of onset of symptoms. Among novel biochemical markers of AMI, heart-type fatty acid binding protein (H-FABP) is of particular interest.

Aim: To compare the diagnostic value of H-FABP with that of CK-MB and myoglobin in suspected AMI patients within first 6 hours after the onset of symptoms.

Settings and design: The study includes 40 AMI cases and 40 non-cardiac chest pain otherwise healthy controls. The cases and controls were further divided into 2 groups depending on the time since chest pain as those subjects within 3 hours and those between 3-6 hours of onset of chest pain.

Materials and methods: In all the cases and controls, serum H-FABP, CK-MB and myoglobin concentrations were measured by Immunoturbidimetric method, immuno-inhibition method and Chemiluminescence immunoassay respectively.

Statistical analysis: Data is presented as mean ± SD values. Differences between means of two groups were assessed by Student t-test. Sensitivity, Specificity, Positive predictive value, Negative predictive values were calculated and ROC curve analysis was done to assess the diagnostic validity of each study parameter.

Results: The sensitivity, specificity, PPV, NPV of H-FABP were greater than CK-MB and myoglobin and ROC curve analysis demonstrated highest area under curve for H-FABP followed by myoglobin and CK-MB in patients with suspected AMI both within 3 hours and 3-6 hours after the onset of chest pain.

Conclusion: The diagnostic efficiency of H-FABP is greater than CK-MB and myoglobin for the early diagnosis of AMI within first 6 hours of chest pain. H-FABP can be used as an additional diagnostic tool for the early diagnosis of AMI.

Keywords: Chest pain; Diagnostic validity; Immunoturbidimetric method; ROC analysis; Sensitivity.

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Figures

[Table/Fig-4]:
[Table/Fig-4]:
ROC curve analysis of CK-MB, Myoglobin & H-FABP in 0-3 hour group
[Table/Fig-5]:
[Table/Fig-5]:
ROC curve analysis of CK-MB, Myoglobin & H-FABP in 3-6 hour group
See this image and copyright information in PMC

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