Heart-type fatty acid-binding protein detects more patients with non-ST segment elevation myocardial infarction compared to troponin-T

ObjectiveTo assess the value of using heart-type fatty acid-binding protein (H-FABP) as a marker of acute myocardial infarction (AMI) in patients presenting with non-ST segment elevation ACS (NSTE-ACS) in comparison with troponin-T (cTnT).Methods122 consecutive patients presented with ischemic-type chest pain within the first 4 h of symptom onset with NSTE-ACS. Blood samples were obtained on arrival for H-FABP and cTnT. Patients with cTnT negative test on admission had a repeat analysis 6 h later. Patients with both H-FABP negative and admission cTnT positive had repeat analysis of H-FABP 6 h later.ResultsOn admission, H-FABP was positive in 84 patients (68.9%) versus 36 patients (29.5%) with cTnT (p = 0.032). On repeat analysis after 6 h, total number of cTnT positive patients was 94 (77%) and cTnT negative was 28 (23%). All cTnT negative patients had negative H-FABP. Of cTnT positive patients, 84 (89.4%) had positive H-FABP test while the remaining 10 (10.6%) had “false” negative results.Using the final results of cTnT positive as gold standard, early assessment of cTnT within 4 h of chest pain had sensitivity of 38.3% and specificity of 100% while H-FABP had sensitivity of 89.4% and specificity of 100%.ConclusionsFor patients presenting with suspected ACS within 4 h of onset of symptoms, H-FABP detects a significantly larger number of patients with NSTEMI compared to troponin-T.