Measurement of myocardial infarct size from plasma fatty acid-binding protein or myoglobin, using individually estimated clearance rates

Abstract

Using individually estimated clearance rates, renal insufficiency no longer hampers calculation of infarct size from FABP and MYO, and reliable estimates of total myocardial damage can be obtained within 24 h after first symptoms.

Brain- and Heart-Type Fatty Acid-Binding Proteins in the Brain: Tissue Distribution and Clinical Utility

“…However, we found no significant correlations among serum concentrations of each of the biomarkers: only 45% of the samples had increases in both B-FABP and H-FABP, suggesting either different release kinetics or injury in different areas of the brain. The latter seems more likely because the release kinetics are not expected to differ among types of FABP (14,36 ). The FABPs, as well as myoglobin and S100B, are cytosolic proteins and, therefore, are released simultaneously from injured cells.…”

Unbound Free Fatty Acids and Heart-Type Fatty Acid–Binding Protein: Diagnostic Assays and Clinical Applications

“…Because H-FABP and myoglobin rapidly return to their respective URLs (within 24 h after AMI) as a result of renal clearance (23,52 ), both proteins can be used to assess a recurrent infarction within 10 h after first AMI (58 ), which might be missed by CK-MB, cTnT, and cTnI because plasma concentrations of these markers return much more slowly to reference (62 ). These differences in release kinetics do not impact the measurement of cardiac proteins in plasma, however (32,58,62 ). Because H-FABP is cleared by the kidneys, renal insufficiency could potentially impact its clinical utility; however, data from de Groot et al (32 ) indicate that individually estimated clearance rates can be applied successfully for infarct size estimation.…”

“…These differences in release kinetics do not impact the measurement of cardiac proteins in plasma, however (32,58,62 ). Because H-FABP is cleared by the kidneys, renal insufficiency could potentially impact its clinical utility; however, data from de Groot et al (32 ) indicate that individually estimated clearance rates can be applied successfully for infarct size estimation. The rapid release of H-FABP can also be used for the detection of successful coronary reperfusion in patients with AMI (63)(64)(65).…”

Relationship between Heart-Type Fatty Acid-Binding Protein Levels and the Risk of Death in Patients with Serious Condition on Arrival at the Emergency Department

“…Its dynamic features of liberation into circulating blood resemble those of myoglobin but are characterized by high specificity to myocardium. Nevertheless, H-FABP is slightly inferior to troponin and CK-MB in diagnostic specificity for AMI and has been described to be increased in other cardiogenic disorders, renal dysfunction, and disorders associated with skeletal muscle damage (1,(10)(11)(12)(13).…”

“…As H-FABP appears in the circulating blood as early as 1.5 hours after onset of AMI, it is feasible to make an early diagnosis of AMI within 3 hours after onset (3,9). H-FABP liberated into the bloodstream is largely excreted from the kidneys and is eliminated from the blood in 24-36 hours if there is no renal dysfunction (10,11). Its dynamic features of liberation into circulating blood resemble those of myoglobin but are characterized by high specificity to myocardium.…”