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KMID : 0191120110260010047
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Journal of Korean Medical Science
2011 Volume.26 No. 1 p.47 ~ p.52
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Heart-type Fatty Acid Binding Protein as an Adjunct to Cardiac Troponin-I for the Diagnosis of Myocardial Infarction
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Kim Kyung-Su
Lee Hui-Jai
Kim Kyu-Seok
Jo You-Hwan
Kim Tae-Yun
Lee Jin-Hee
Rhee Joong-Eui
Suh Gil-Joon
Kim Mi-Ran
Lee Christopher C.
Singer Adam J.
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Abstract
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We hypothesized that when used in combination with cardiac troponins, heart-type fatty acid binding protein (H-FABP) would have greater diagnostic value than conventional markers for the early diagnosis of myocardial infarction (MI). Patients with typical chest pain at a single emergency department were consecutively enrolled. Initial blood samples were drawn for H-FABP, myoglobin, creatine kinase isoenzyme MB (CK-MB), and cardiac troponin-I (cTnI) measurements. MI was defined by serial cTnI measurements. To evaluate the adjunctive role of biochemical markers, we derived and compared logistic regression models predicting MI in terms of their discrimination (area under the receiver operating characteristics curve, AUC) and overall fit (Bayesian information criterion, BIC). Seventy-six of 170 patients were diagnosed as having MI. The AUC of cTnI, H-FABP, myoglobin, and CK-MB were 0.863, 0.827, 0.784, and 0.772, respectively. A logistic regression model using cTnI (P = 0.001) and H-FABP (P < 0.001) had the biggest AUC (0.900) and the best fit determined by BIC. Sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of this model at 30% probability were 81.6%, 80.9%, 4.26, and 0.23, respectively. H-FABP has a better diagnostic value than both myoglobin and CK-MB as an adjunct to cTnI for the early diagnosis of MI.
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KEYWORD
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Myocardial Infarction, Fatty Acid-Binding Proteins, Point-of-Care Systems, Chest Pain
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