Heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction: a systematic review and meta-analysis

Abstract

Heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction: a systematic review and meta-analysis Bruins Slot, M.H.E.; Reitsma, J.B.; Rutten, F.H.; Hoes, A.W.; van der Heijden, G.J.M.G. General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. Download date: 28 Apr 2019Heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction: a systematic review and meta-analysis Main outcome measures A summary estimate for sensitivity and specificity was calculated using the bivariate random-effects approach, and covariate analysis was used to examine sources of heterogeneity between studies.Results A systematic search yielded 16 studies (3709 patients, prevalence of AMI 13e74%, male gender 49e84%, median age 64e76 years). The summary estimate was 84% (95% CI 76% to 90%) for sensitivity and 84% (95% CI 76% to 89%) for specificity. Covariate analyses revealed that the use of troponin in the reference standard for AMI (as opposed to creatine kinase or creatine kinase-myocardial band) had a significant impact on sensitivity. Conclusion H-FABP does not fulfil the requirements needed for a safe and early diagnosis of AMI when used as a stand-alone test. Sound diagnostic studies examining the additional role of H-FABP combined with clinical findings and other diagnostic tests are needed to further clarify a potential future role for this cardiac biomarker.

Plasma reference value of heart-type fatty acid-binding protein, the earliest available plasma biomarker of acute myocardial infarction

“…Various clinical studies have assessed the diagnostic performance of H-FABP in the early diagnosis of AMI and the receiver operating characteristic (ROC) curve analyses have reported cut-off levels for a positive test ranging from 3.3 to 12 ng/mL [6,13,14]. The 99th centile value of 5.6 ng/mL agrees with this range of reported cut-off levels.…”

Comparison of contemporary troponin assays with the novel biomarkers, heart fatty acid binding protein and copeptin, for the early confirmation or exclusion of myocardial infarction in patients presenting to the emergency department with chest pain

“…The results of meta analysis has been mixed with early reports that hFABP does not meet the criteria for an early diagnostic test14 15 but more recent studies supporting a degree of added value for additional measurement of HFABP plus cTn but at the expense of a significant reduction in diagnostic specificity 16. HFABP has been shown to be a prognostic marker in patients with chest pain and suspected ACSs17–19 suggesting its role may be an ischaemia marker rather than a necrosis marker alone.…”

Heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction: a systematic review and meta-analysis

“…To the Editor We read with interest the systematic review and meta-analysis by Bruins Slot et al concerning early diagnosis of myocardial infarction (MI) using heart-type fatty acid-binding protein (H-FABP) 1. We agree with their summary that when used in isolation, H-FABP may not offer a diagnostic advantage over the current troponin standard.…”