Heart Fatty Acid Binding Protein (H-FABP) as a Diagnostic Biomarker in Patients with Acute Coronary Syndrome

Gururajan, Priya; Gurumurthy, Prema; Nayar, Pradeep G; Rao, G. Srinivasa Nageswara; Babu, Sai; Cherian, K.M.

doi:10.1016/j.hlc.2010.06.665

Cited by 41 publications

(33 citation statements)

References 14 publications

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“…As a single diagnostic test, measurement of H-FABP is not reliable for the diagnosis of patients presenting with acute chest pain and a suspected AMI. In RATPAC-CBE the diagnostic sensitivity of H-FABP and the AUC by ROC curve analysis are comparable to those reported previously 69,[71][72][73]79 although there is one report that found much higher values. 71 The role of H-FABP is therefore as a supplementary test.…”

Section: Role Of Novel Cytoplasmic Biomarkerssupporting

confidence: 86%

“…When compared with a conventional troponin assay, measurement of H-FABP was found to provide additional diagnostic sensitivity for early presentation. 69,71,72 However, the reported sensitivity of the cardiac troponin assays are low and the specificity of H-FABP is also low. Two meta-analyses have suggested that H-FABP does not meet the criteria for an early diagnostic test.…”

Section: Fatty Acid-binding Proteinmentioning

confidence: 99%

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Randomised Assessment of Treatment using Panel Assay of Cardiac markers – Contemporary Biomarker Evaluation (RATPAC CBE)

Collinson

Gaze²,

Thokala³

et al. 2013

Health Technol Assess

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Reports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: http://www.hta.ac.uk/ This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 09/22/16. The contractual start date was in August 2010. The draft report began editorial review in February 2012 and was accepted for publication in June 2012. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health. Published by the NIHR Journals Library, produced by Prepress Projects Ltd, Perth, Scotland (www.prepress-projects.co.uk). Objectives: To test the diagnostic accuracy for detecting an acute myocardial infarction (AMI) using highly sensitive troponin assays and a range of new cardiac biomarkers of plaque destabilisation, myocardial ischaemia and necrosis; to test the prognostic accuracy for detecting adverse cardiac events using highly sensitive troponin assays and this range of new cardiac biomarkers; and to estimate the cost-effectiveness of using highly sensitive troponin assays or this range of new cardiac biomarkers instead of an admission and 10-to 12-hour troponin measurement. NIHR Journals LibraryDesign: Substudy of the point-of-care arm of the RATPAC (Randomised Assessment ...

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Section: Role Of Novel Cytoplasmic Biomarkerssupporting

confidence: 86%

Section: Fatty Acid-binding Proteinmentioning

confidence: 99%

Randomised Assessment of Treatment using Panel Assay of Cardiac markers – Contemporary Biomarker Evaluation (RATPAC CBE)

Collinson

Gaze²,

Thokala³

et al. 2013

Health Technol Assess

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“…Our study result was in complete agreement with the above studies presenting with 53 and 97 % sensitivity and specificity for Troponin T and 78 and 70 % for h-FABP respectively. The low h-FABP specificity of 42-70 % in similar settings was also reported by number of other investigators [7,10,[15][16][17]. The reasons for the poor specificity of h-FABP for the final diagnosis of AMI have been due its presence in tissues outside the heart or may be because renal insufficiency [18].…”

Section: Discussionsupporting

confidence: 59%

“…The reason for this sensitivity has been explained by its small molecular weight (15 kDa) and its cytoplasmic unbound abundance, resulting in rapid release from damaged myocardium. Authors [7,10,15] have reported sensitivity and specificity as 42-67 % and 95-97 % respectively for troponin whereas for h-FABP, 75-87 % and 89-93 %, in patients admitted with 6 h of chest pain onset. Our study result was in complete agreement with the above studies presenting with 53 and 97 % sensitivity and specificity for Troponin T and 78 and 70 % for h-FABP respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Following myocardial cell damage, this small protein diffuses much more rapidly than troponins through the interstitial space and appears in the circulation probably through a trans-endothelial pathway [9]. This protein can be detected in the blood as early as 1-3 h after onset of chest pain, with peak values reached at 6-8 h and plasma levels returning to normal within 24-30 h [10]. Thus, h-FABP appears to be a very stable protein for early detection of myocardial necrosis and can be useful for in vitro clinical diagnostic purposes.…”

Section: Introductionmentioning

confidence: 99%

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Troponin T and Heart Type Fatty Acid Binding Protein (h-Fabp) as Biomarkers in Patients Presenting with Chest Pain

et al. 2015

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Acute coronary syndrome (ACS) is a term for a range of clinical signs and symptoms suggestive of myocardial ischemia. It results in functional and structural changes and ultimately releasing protein from injured cardiomyocytes. These cardiac markers play a major role in diagnosis and prognosis of ACS. This study aims to assess the efficacy of heart type fatty acid binding protein (h-FABP) as a marker for ACS along with the routinely used hs-TropT. In our observational study, plasma h-FABP (cut-off 6.32 ng/ml) and routinely done hs-Trop T (cutoff 0.1 and 0.014 ng/ml) were estimated by immunometric laboratory assays in 88 patients with acute chest pain. Based on the clinical and laboratory test findings the patients were grouped into ACS (n = 41) and non-ACS (n = 47). The diagnostic sensitivity, specificity, NPV, PPV and ROC curve at 95 % CI were determined. Sensitivity of hs-TropT (0.1 ng/ml), hs-TropT (0.014 ng/ml) and h-FABP were 53, 86 and 78 % respectively and specificity for the same were 98, 73 and 70 % respectively. Sensitivity, specificity and NPV calculated for a cut-off combination of hs-TropT 0.014 ng/ml and h-FABP was 100, 51 and 100 % respectively. These results were substantiated by ROC analysis. Measurement of plasma h-FABP and hs-TropT together on admission appears to be more precise predictor of ACS rather than either hs-Trop T or h-FABP.

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Unstable Angina and Non-ST Segment Elevation Myocardial Infarction (Acute Coronary Syndromes)

Mehta

Kleiman

2013

Essential Cardiology

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Heart Fatty Acid Binding Protein (H-FABP) as a Diagnostic Biomarker in Patients with Acute Coronary Syndrome

Cited by 41 publications

References 14 publications

Randomised Assessment of Treatment using Panel Assay of Cardiac markers – Contemporary Biomarker Evaluation (RATPAC CBE)

Randomised Assessment of Treatment using Panel Assay of Cardiac markers – Contemporary Biomarker Evaluation (RATPAC CBE)

Troponin T and Heart Type Fatty Acid Binding Protein (h-Fabp) as Biomarkers in Patients Presenting with Chest Pain

Unstable Angina and Non-ST Segment Elevation Myocardial Infarction (Acute Coronary Syndromes)

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