Downloads
Abstract
Background: Acute Coronary Syndrome (ACS) is a leading cause of mortality and morbidity worldwide, highlighting the need for rapid and accurate diagnostic methods to improve patient outcomes. Heart-type Fatty Acid Binding Protein (H-FABP) has shown potential as an early biomarker for the detection of Acute Myocardial Infarction (AMI) in its initial stages.
Methods: This study was conducted on a cohort of 103 ACS patients admitted within 6 hours of symptom onset at Military Hospital 175 between August 2018 and July 2020. Blood samples were collected and analyzed at two time points to measure levels of H-FABP and high-sensitivity troponin T (hs-troponin T). The diagnostic performance of H-FABP and hs-troponin T was evaluated through sensitivity, specificity, and area under the curve (AUC) analysis.
Results: H-FABP demonstrated robust early diagnostic accuracy for AMI, with a sensitivity of 90.5% and specificity of 89.5% at a cutoff value of 7.13 ng/ml. Results indicate that H-FABP outperforms troponin in early AMI diagnosis, particularly within the first 3 hours when troponin levels may not yet have significantly risen.
Conclusion: H-FABP is an effective biomarker for the early diagnosis of AMI in patients presenting within 6 hours of symptom onset. When combined with hs-troponin T, H-FABP enhances diagnostic sensitivity and specificity, offering a critical advantage in cases requiring urgent diagnosis within the initial 3 hours.
References
Thygesen K. Fourth universal definition of myocardial infarction (2018). Circulation. 2018; 138(20): e618-e651.
Saito Y, Oyama K, Tsujita K, Yasuda S, and Kobayashi Y. Treatment strategies of acute myocardial infarction: updates on revascularization, pharmacological therapy, and beyond. J Cardiol. 2023; 81(2): 168-178.
Adams J, Trent R, and Rawles J. Earliest electrocardiographic evidence of myocardial infarction: implications for thrombolytic treatment. The GREAT Group. British Medical Journal. 1993; 307(6901): 409-413.
Thygesen K. 'Ten Commandments' for the Fourth Universal Definition of Myocardial Infarction 2018. Eur Heart J. 2019; 40(3): 226.
Sandoval Y. High-Sensitivity Cardiac Troponin and the 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guidelines for the Evaluation and Diagnosis of Acute Chest Pain. Circulation. 2022; 146(7): 569-581.
Roffi M. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J. 2016; 37(3): 267-315.
Tiwari RP. Cardiac troponins I and T: molecular markers for early diagnosis, prognosis, and accurate triaging of patients with acute myocardial infarction. Molecular diagnosis & therapy. 2012; 16: 371-381.
Kleine AH, Glatz JF, Van Nieuwenhoven FA, and Van der Vusse GJ. Release of heart fatty acid-binding protein into plasma after acute myocardial infarction in man. Mol Cell Biochem. 1992; 116(1-2): 155-62.
Kakoti A and Goswami P. Heart type fatty acid binding protein: structure, function and biosensing applications for early detection of myocardial infarction. Biosens Bioelectron. 2013; 43: 400-11.
Alhadi H and Fox K. Do we need additional markers of myocyte necrosis: the potential value of heart fatty-acid-binding protein. Qjm. 2004; 97(4): 187-198.
Thoa GT, Hiếu NL, and Minh HV. Nghiên cứu sự biến đổi nồng độ H-FABP trong chẩn đoán sớm nhồi máu cơ tim cấp. Tạp chí Y dược học, trường Đại Học Y dược Huế. 2016;30: 86-92.
Phong NT, Sơn PN, and Sơn NH. Nghiên cứu mối liên quan giữa nồng độ H-FABP với một số biến cố tim mạch và tử vong trong thời gian nằm viện và 30 ngày sau nhồi máu cơ tim có ST chênh lên. Journal of 108-Clinical Medicine and Phamarcy. 2021.
Trần Văn Thi. Nghiên cứu nồng độ hsCRP và TNFα huyết thanh ở bệnh nhân bệnh mạch vành có hay không có bệnh phổi tắc nghẽn mạn tính. Luận án tiến sĩ y học. 2016, Đại học Y Dược Huế.
Kitamura M, et al. Different characteristics of cardiac biomarkers to decide and predict the culprit lesions in patients with suspicious acute coronary syndrome. Heart Vessels. 2016; 31(6): 907-17.
Neumann JT. Diagnosis of Myocardial Infarction Using a High-Sensitivity Troponin I 1-Hour Algorithm. JAMA Cardiol. 2016; 1(4): 397-404.
McMahon CG, et al. Diagnostic accuracy of heart-type fatty acid-binding protein for the early diagnosis of acute myocardial infarction. Am J Emerg Med. 2012; 30(2): 267-74.
Cubranic Z. Diagnostic accuracy of heart fatty acid binding protein (H-FABP) and glycogen phosphorylase isoenzyme BB (GPBB) in diagnosis of acute myocardial infarction in patients with acute coronary syndrome. Biochem Med (Zagreb). 2012; 22(2): 225-36.
Willemsen RT, et al. Heart-type fatty acid binding protein (H-FABP) in patients in an emergency department setting, suspected of acute coronary syndrome: optimal cut-off point, diagnostic value and future opportunities in primary care. Eur J Gen Pract. 2015; 21(3): 156-63.
Tanaka T, Hirota Y, Sohmiya K, Nishimura S, and Kawamura K. Serum and urinary human heart fatty acid-binding protein in acute myocardial infarction. Clin Biochem. 1991; 24(2): 195-201.
| Published | 21-12-2024 | |
| Fulltext |
|
|
| Language |
|
|
| Issue | Vol. 16 No. 9 (2024) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.16.9.8 | |
| Keywords | H-FABP, hs Troponin T, nhồi máu cơ tim cấp, hội chứng mạch vành cấp H-FABP, hs-troponin T, acute myocardial infarction, acute coronary syndrome |
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2024 Journal of Clinical Medicine Hue Central Hospital