Performances of the heart fatty acid protein assay for the rapid diagnosis of acute myocardial infarction in ED patients

Dupuy, Anne‐Marie; Cristol, Jean Paul; Kuster, Nils; Reynier, Robin; Lefebvre, Sophie; Badiou, Stéphanie; Jreige, Riad; Sebbane, Mustapha

doi:10.1016/j.ajem.2014.11.012

Cited by 18 publications

(11 citation statements)

References 11 publications

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“…It is a cytoplasmic protein which was first isolated from ischemic rat hearts in 1988, and was identified as being released from injured myocardium 4 , 5 . Associations between H-FABP and ACS 6 – 8 , acute kidney injury 9 , post-cardiac surgery 10 , acute pulmonary embolism 11 , acute ischemic stroke 12 , severe sepsis 13 , acute heart failure 14 , hypothyroidism 15 and hyperthyroidism 16 have been reported over the past decades. On the other hand, H-FABP has also been used to assess perioperative cardiac risk 17 , 18 .…”

Section: Introductionmentioning

confidence: 99%

The prognostic significance of heart-type fatty acid binding protein in patients with stable coronary heart disease

Tseng

et al. 2018

Sci Rep

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To investigate the prognostic value of heart-type fatty acid binding protein (H-FABP) in patients with stable coronary heart disease (SCHD). A total of 1,071 patients with SCHD were prospectively enrolled in this Taiwan multicenter registry study, followed for 24 months. The cut-off value of H-FABP, 4.143 pg/mL, was determined using receiver operating characteristic curves. The primary cardiovascular (CV) outcome was composite CV events, defined as cardiovascular or cerebrovascular death, myocardial infarction (MI), stroke, angina related-hospitalization, PAOD-related hospitalization and heart failure. Secondary outcomes included CV or cerebrovascular death, nonfatal MI, nonfatal stroke, and acute heart failure-related hospitalization. We found that the high H-FABP group had more than a two-fold higher rate of primary CV outcomes than the low H-FABP group (32.36% vs. 15.78%, p < 0.001). Eleven patients (4.82%) of the high H-FABP group died during the 24 months of follow-up, compared to only one patient (0.12%) in the low H-FABP group. The acute heart failure-related hospitalization rate was also significantly higher in the high H-FABP group (3.5% vs. 0.95%, p < 0.005). The results remained significant after adjusting for baseline covariates. In conclusion, H-FABP was an independent predictor for CV outcomes in the patients with SCHD, mainly in CV death and acute heart failure-related hospitalization.

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Section: Introductionmentioning

confidence: 99%

The prognostic significance of heart-type fatty acid binding protein in patients with stable coronary heart disease

Tseng

et al. 2018

Sci Rep

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“…Studies that have used a high-sensitivity cardiac troponin T assay have concluded that HFABP (using the semi-automated method) does not add significantly to diagnostic efficiency (6,(17)(18)(19). The other study, which has used the automated assay, showed an increased diagnostic sensitivity when HFABP was added to a high-sensitivity troponin (20).…”

Section: Discussionmentioning

confidence: 99%

Heart Fatty Acid Binding Protein for the Diagnosis of Myocardial Ischemia and Infarction

Collinson

Hersey

Bray

et al. 2017

The Journal of Applied Laboratory Medicine

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Objective: To establish the analytical performance of a heart fatty acid binding protein (HFABP) method suitable for routine clinical use and examine its role for the diagnosis of myocardial ischemia and myocardial infarction. Methods: Analyses of HFABP were performed on an Advia 2400 (Siemens Healthcare Diagnostics). Imprecision, limit of detection (LOD), limit of blank (LOB), and linearity were assessed using standard methods. Stability was assessed at 4°C, −20°C, and with 3 repeated freeze-thaw cycles. Clinical diagnostic performance was assessed using chest pain in patients, with a final diagnosis according to the universal definition of myocardial infarction with cardiac troponin I (cTnI) measured on the Siemens Advia Centaur (cTnI Ultra method, 99th percentile 50 ng/L, 10% CV 30 ng/L). Ischemia was detected using sampling pre-and postangioplasty. Results: LOD and analytical imprecision exceeded the manufacturer's specification (LOD 1.128 μg/L, 20% CV 1.3 μg/L, 10% CV 2.75 μg/L). Clinical diagnostic efficiency was less than cTnI. Addition of HFABP to cTnI produced a modest increase in diagnostic sensitivity at a cost of significant loss of specificity. Conclusions: Although the test had excellent analytical performance, it did not contribute to the clinical diagnosis of patients with chest pain. HFABP appears to be a marker of myocardial infarction not myocardial ischemia. IMPACT STATEMENT In this study, the performance characteristics of a fully automated assay for heart fatty acid binding protein (HFABP) were confirmed against the manufacturer's specification. The clinical role was examined for the early diagnosis of acute myocardial infarction (AMI) in patients presenting with chest pain and in patients undergoing percutaneous intervention as a model of myocardial ischemia. The assay met performance specifications. HFABP is a marker of myocardial necrosis, not myocardial ischemia, and does improve early sensitivity for detection of AMI but results in a significant loss of diagnostic specificity when combined with cardiac troponin measurement.

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“…e assessment of HFABP at the ED admission adds an incremental value to the initial hs-cTnT. e increase in the sensitivity and negative predictive value for patients with chest pain with noncontributive electrocardiogram could potentially allow safe and early rule-out of AMI without the need for further serial troponin testing [98]. In the patients presenting to the ED with chest pain and no cTnI elevations, hFABP showed a higher sensitivity in the diagnosis of AMI with a positive rate of 55%.…”

Section: Heart-type Fatty Acid Binding Protein (Hfabp)mentioning

confidence: 99%

The Biomarkers for Acute Myocardial Infarction and Heart Failure

Wang

Zhang

et al. 2020

BioMed Research International

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The use of a large number of cardiovascular biomarkers, meant to complement the use of the electrocardiogram, echocardiography cardiac imaging, and clinical symptom assessment, has become a routine in clinical diagnosis, differential diagnosis, risk stratification, and prognosis and guides the management of patients with suspected cardiovascular diseases. There is a broad consensus that cardiac troponin and natriuretic peptides are the preferred biomarkers in clinical practice for the diagnosis of the acute coronary syndrome and heart failure, respectively, while the roles and possible clinical applications of several other potential biomarkers are still under study. This review mainly focuses on the recent studies of the roles and clinical applications of troponin and natriuretic peptides, which seem to be the best-validated markers in distinguishing and predicting the future cardiac events of patients with suspected cardiovascular diseases. Additionally, the review briefly discusses some of the large number of potential markers that may play a more prominent role in the future.

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Performances of the heart fatty acid protein assay for the rapid diagnosis of acute myocardial infarction in ED patients

Cited by 18 publications

References 11 publications

The prognostic significance of heart-type fatty acid binding protein in patients with stable coronary heart disease

The prognostic significance of heart-type fatty acid binding protein in patients with stable coronary heart disease

Heart Fatty Acid Binding Protein for the Diagnosis of Myocardial Ischemia and Infarction

The Biomarkers for Acute Myocardial Infarction and Heart Failure

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