Human heart-type fatty-acid-binding protein as a point-of-care test in the early diagnosis of acute myocardial infarction
Background: At very early stages of acute myocardial infarction (AMI), highly sensitive biomarkers are still lacking. Aim: To evaluate the utility of human heart-type fatty acid-binding protein (h-FABP) for early diagnosis of AMI. Design: Prospective diagnostic study. Methods: Consecutive patients p...
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| Veröffentlicht in: | QJM : An International Journal of Medicine 2007-04, Vol.100 (4), p.203-210 |
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| creator | Mad, P. Domanovits, H. Fazelnia, C. Stiassny, K. Russmüller, G. Cseh, A. Sodeck, G. Binder, T. Christ, G. Szekeres, T. Laggner, A. Herkner, H. |
| description | Background: At very early stages of acute myocardial infarction (AMI), highly sensitive biomarkers are still lacking.
Aim: To evaluate the utility of human heart-type fatty acid-binding protein (h-FABP) for early diagnosis of AMI.
Design: Prospective diagnostic study.
Methods: Consecutive patients presenting to the emergency department with chest pain or dyspnoea within 24 h of symptom onset were included. At presentation, the h-FABP test result was compared to the standard diagnostic work-up, including repeated ECG and troponin T measurements. Sensitivity analysis was performed for inconclusive tests.
Results: We enrolled 280 patients presenting to hospital with a median symptom onset of 3 h (IQR 2-6 h): 109 (39%) had AMI. At presentation, h-FABP had a sensitivity of 69% (95%CI 59-77) and specificity of 74% (95%CI 66-80); 45 tests were false-positive and 34 were false-negative. Omitting inconclusive tests increased sensitivity and specificity only slightly. AMI was identified significantly earlier by h-FABP than by troponin T (24 vs. 8 patients, p = 0.005).
Discussion: Although h-FABP can help to detect myocardial damage at an early stage in patients with chest pain or dyspnoea, it appears unsuitable as a stand-alone test for ruling out AMI. |
| doi_str_mv | 10.1093/qjmed/hcm007 |
| format | Article |
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Aim: To evaluate the utility of human heart-type fatty acid-binding protein (h-FABP) for early diagnosis of AMI.
Design: Prospective diagnostic study.
Methods: Consecutive patients presenting to the emergency department with chest pain or dyspnoea within 24 h of symptom onset were included. At presentation, the h-FABP test result was compared to the standard diagnostic work-up, including repeated ECG and troponin T measurements. Sensitivity analysis was performed for inconclusive tests.
Results: We enrolled 280 patients presenting to hospital with a median symptom onset of 3 h (IQR 2-6 h): 109 (39%) had AMI. At presentation, h-FABP had a sensitivity of 69% (95%CI 59-77) and specificity of 74% (95%CI 66-80); 45 tests were false-positive and 34 were false-negative. Omitting inconclusive tests increased sensitivity and specificity only slightly. AMI was identified significantly earlier by h-FABP than by troponin T (24 vs. 8 patients, p = 0.005).
Discussion: Although h-FABP can help to detect myocardial damage at an early stage in patients with chest pain or dyspnoea, it appears unsuitable as a stand-alone test for ruling out AMI.</description><identifier>ISSN: 1460-2725</identifier><identifier>EISSN: 1460-2393</identifier><identifier>DOI: 10.1093/qjmed/hcm007</identifier><identifier>PMID: 17347171</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Biological and medical sciences ; Cardiology. Vascular system ; Coronary heart disease ; Early Diagnosis ; Fatty Acid Binding Protein 3 ; Fatty Acid-Binding Proteins - blood ; Female ; General aspects ; Heart ; Humans ; Male ; Medical sciences ; Middle Aged ; Myocardial Infarction - diagnosis ; Point-of-Care Systems - standards ; Predictive Value of Tests</subject><ispartof>QJM : An International Journal of Medicine, 2007-04, Vol.100 (4), p.203-210</ispartof><rights>The Author 2007. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org 2007</rights><rights>2007 INIST-CNRS</rights><rights>Copyright Oxford University Press(England) Apr 2007</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c444t-f3c6c2b032bcbc5f4240b71085a738e3663858d8db13f93e97b8cf61b7b438c33</citedby><cites>FETCH-LOGICAL-c444t-f3c6c2b032bcbc5f4240b71085a738e3663858d8db13f93e97b8cf61b7b438c33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1584,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18699926$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17347171$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mad, P.</creatorcontrib><creatorcontrib>Domanovits, H.</creatorcontrib><creatorcontrib>Fazelnia, C.</creatorcontrib><creatorcontrib>Stiassny, K.</creatorcontrib><creatorcontrib>Russmüller, G.</creatorcontrib><creatorcontrib>Cseh, A.</creatorcontrib><creatorcontrib>Sodeck, G.</creatorcontrib><creatorcontrib>Binder, T.</creatorcontrib><creatorcontrib>Christ, G.</creatorcontrib><creatorcontrib>Szekeres, T.</creatorcontrib><creatorcontrib>Laggner, A.</creatorcontrib><creatorcontrib>Herkner, H.</creatorcontrib><title>Human heart-type fatty-acid-binding protein as a point-of-care test in the early diagnosis of acute myocardial infarction</title><title>QJM : An International Journal of Medicine</title><addtitle>QJM</addtitle><description>Background: At very early stages of acute myocardial infarction (AMI), highly sensitive biomarkers are still lacking.
Aim: To evaluate the utility of human heart-type fatty acid-binding protein (h-FABP) for early diagnosis of AMI.
Design: Prospective diagnostic study.
Methods: Consecutive patients presenting to the emergency department with chest pain or dyspnoea within 24 h of symptom onset were included. At presentation, the h-FABP test result was compared to the standard diagnostic work-up, including repeated ECG and troponin T measurements. Sensitivity analysis was performed for inconclusive tests.
Results: We enrolled 280 patients presenting to hospital with a median symptom onset of 3 h (IQR 2-6 h): 109 (39%) had AMI. At presentation, h-FABP had a sensitivity of 69% (95%CI 59-77) and specificity of 74% (95%CI 66-80); 45 tests were false-positive and 34 were false-negative. Omitting inconclusive tests increased sensitivity and specificity only slightly. AMI was identified significantly earlier by h-FABP than by troponin T (24 vs. 8 patients, p = 0.005).
Discussion: Although h-FABP can help to detect myocardial damage at an early stage in patients with chest pain or dyspnoea, it appears unsuitable as a stand-alone test for ruling out AMI.</description><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Coronary heart disease</subject><subject>Early Diagnosis</subject><subject>Fatty Acid Binding Protein 3</subject><subject>Fatty Acid-Binding Proteins - blood</subject><subject>Female</subject><subject>General aspects</subject><subject>Heart</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Point-of-Care Systems - standards</subject><subject>Predictive Value of Tests</subject><issn>1460-2725</issn><issn>1460-2393</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90U1vFSEUBmBiavq9c21IE-tGWr7uAEvTqDVp4sauJ8BALzczMAVmMf9e6r3VxIUrCOfJ4Zy8ALwj-IZgxW6fd5Mbbrd2wli8AaeEdxhRptjR613QzQk4K2WHMeaCy2NwQgTjgghyCtb7ZdIRbp3OFdV1dtDrWlekbRiQCXEI8QnOOVUXItQFajinECtKHlmdHayuVNhKdetg6zGucAj6KaYSCkweartUB6c1NdwKY6NeZ1tDihfgrddjcZeH8xw8fv3y8-4ePfz49v3u8wOynPOKPLOdpQYzaqyxG88px0YQLDdaMOlY1zG5kYMcDGFeMaeEkdZ3xAjDmbSMnYPrfd-2xfPSxu2nUKwbRx1dWkovMFMUS9zg1T9wl5Yc22w9pYoLSaVq6NMe2ZxKyc73cw6TzmtPcP-SR_87j36fR-PvDz0X8_L8Bx8CaODDAehi9eizjjaUv052SinaNfdx79Iy___LX1ZRoro</recordid><startdate>20070401</startdate><enddate>20070401</enddate><creator>Mad, P.</creator><creator>Domanovits, H.</creator><creator>Fazelnia, C.</creator><creator>Stiassny, K.</creator><creator>Russmüller, G.</creator><creator>Cseh, A.</creator><creator>Sodeck, G.</creator><creator>Binder, T.</creator><creator>Christ, G.</creator><creator>Szekeres, T.</creator><creator>Laggner, A.</creator><creator>Herkner, H.</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20070401</creationdate><title>Human heart-type fatty-acid-binding protein as a point-of-care test in the early diagnosis of acute myocardial infarction</title><author>Mad, P. ; Domanovits, H. ; Fazelnia, C. ; Stiassny, K. ; Russmüller, G. ; Cseh, A. ; Sodeck, G. ; Binder, T. ; Christ, G. ; Szekeres, T. ; Laggner, A. ; Herkner, H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c444t-f3c6c2b032bcbc5f4240b71085a738e3663858d8db13f93e97b8cf61b7b438c33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Coronary heart disease</topic><topic>Early Diagnosis</topic><topic>Fatty Acid Binding Protein 3</topic><topic>Fatty Acid-Binding Proteins - blood</topic><topic>Female</topic><topic>General aspects</topic><topic>Heart</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - diagnosis</topic><topic>Point-of-Care Systems - standards</topic><topic>Predictive Value of Tests</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mad, P.</creatorcontrib><creatorcontrib>Domanovits, H.</creatorcontrib><creatorcontrib>Fazelnia, C.</creatorcontrib><creatorcontrib>Stiassny, K.</creatorcontrib><creatorcontrib>Russmüller, G.</creatorcontrib><creatorcontrib>Cseh, A.</creatorcontrib><creatorcontrib>Sodeck, G.</creatorcontrib><creatorcontrib>Binder, T.</creatorcontrib><creatorcontrib>Christ, G.</creatorcontrib><creatorcontrib>Szekeres, T.</creatorcontrib><creatorcontrib>Laggner, A.</creatorcontrib><creatorcontrib>Herkner, H.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>QJM : An International Journal of Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mad, P.</au><au>Domanovits, H.</au><au>Fazelnia, C.</au><au>Stiassny, K.</au><au>Russmüller, G.</au><au>Cseh, A.</au><au>Sodeck, G.</au><au>Binder, T.</au><au>Christ, G.</au><au>Szekeres, T.</au><au>Laggner, A.</au><au>Herkner, H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Human heart-type fatty-acid-binding protein as a point-of-care test in the early diagnosis of acute myocardial infarction</atitle><jtitle>QJM : An International Journal of Medicine</jtitle><addtitle>QJM</addtitle><date>2007-04-01</date><risdate>2007</risdate><volume>100</volume><issue>4</issue><spage>203</spage><epage>210</epage><pages>203-210</pages><issn>1460-2725</issn><eissn>1460-2393</eissn><abstract>Background: At very early stages of acute myocardial infarction (AMI), highly sensitive biomarkers are still lacking.
Aim: To evaluate the utility of human heart-type fatty acid-binding protein (h-FABP) for early diagnosis of AMI.
Design: Prospective diagnostic study.
Methods: Consecutive patients presenting to the emergency department with chest pain or dyspnoea within 24 h of symptom onset were included. At presentation, the h-FABP test result was compared to the standard diagnostic work-up, including repeated ECG and troponin T measurements. Sensitivity analysis was performed for inconclusive tests.
Results: We enrolled 280 patients presenting to hospital with a median symptom onset of 3 h (IQR 2-6 h): 109 (39%) had AMI. At presentation, h-FABP had a sensitivity of 69% (95%CI 59-77) and specificity of 74% (95%CI 66-80); 45 tests were false-positive and 34 were false-negative. Omitting inconclusive tests increased sensitivity and specificity only slightly. AMI was identified significantly earlier by h-FABP than by troponin T (24 vs. 8 patients, p = 0.005).
Discussion: Although h-FABP can help to detect myocardial damage at an early stage in patients with chest pain or dyspnoea, it appears unsuitable as a stand-alone test for ruling out AMI.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>17347171</pmid><doi>10.1093/qjmed/hcm007</doi><tpages>8</tpages></addata></record> |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals |
| subjects | Biological and medical sciences Cardiology. Vascular system Coronary heart disease Early Diagnosis Fatty Acid Binding Protein 3 Fatty Acid-Binding Proteins - blood Female General aspects Heart Humans Male Medical sciences Middle Aged Myocardial Infarction - diagnosis Point-of-Care Systems - standards Predictive Value of Tests |
| title | Human heart-type fatty-acid-binding protein as a point-of-care test in the early diagnosis of acute myocardial infarction |
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