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

Glatz, Jan F. C.; Mohren, Ronny

doi:10.4236/health.2013.58163

Cited by 14 publications

(9 citation statements)

References 13 publications

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“…The increase in diagnostic sensitivity as a results of adding copeptin measurements to cTnI is 14% (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) in the meta-analysis, which is comparable to the 19.8% increase that we find in our study. 19 Two very recent reports, not included in the meta-analysis, that investigated the added value of copeptin on top of cTnI in the evaluation of chest pain patients have shown mixed results.…”

Section: Discussionsupporting

confidence: 80%

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Rapidly rule out acute myocardial infarction by combining copeptin and heart-type fatty acid-binding protein with cardiac troponin

et al. 2015

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Background: The rapid exclusion of acute myocardial infarction in patients with chest pain can reduce the length of hospital admission, prevent unnecessary diagnostic work-up and reduce the burden on our health-care systems. The combined use of biomarkers that are associated with different pathophysiological aspects of acute myocardial infarction could improve the early diagnostic assessment of patients presenting with chest pain. Methods: We measured cardiac troponin I, copeptin and heart-type fatty acid-binding protein concentrations in 584 patients who presented to the emergency department with acute chest pain. The diagnostic performances for the diagnosis of acute myocardial infarction and NSTEMI were calculated for the individual markers and their combinations. Separate calculations were made for patients presenting to the emergency department <3 h, 3-6 h and 6-12 h after chest pain onset. Results: For ruling out acute myocardial infarction, the net predictive values (95% CI) of cardiac troponin I, copeptin and heart-type fatty acid-binding protein were 90.4% (87.3-92.9), 84% (79.8-87.6) and 87% (83.5-90), respectively. Combining the three biomarkers resulted in a net predictive value of 95.8% (92.8-97.8). The improvement was most pronounced in the early presenters (<3 h) where the combined net predictive value was 92.9% (87.3-96.5) compared to 84.6% (79.4-88.9) for cardiac troponin I alone. The area under the receiver operating characteristic for the triple biomarker combination increased significantly (P < 0.05) compared to that of cardiac troponin I alone (0.880 [0.833-0.928] vs. 0.840 [0.781-0.898], respectively). Conclusions: Combining copeptin, heart-type fatty acid-binding protein and cardiac troponin I measurements improves the diagnostic performance in patients presenting with chest pain. Importantly, in patients who present early (<3 h) after chest pain onset, the combination improves the diagnostic performance compared to the standard cardiac troponin I measurement alone.

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Section: Discussionsupporting

confidence: 80%

“…4,15 H-FABP was measured using a direct non-competitive enzyme-linked immunosorbent assay, as described previously. 16,17 The detection limit for this assay is 0.25 ng/mL, with a detection range up to 32 ng/mL. The coefficients of variation at 5, 12 and 25 ng/mL is 4%, 5% and 7%, respectively.…”

Section: Biochemical Analysismentioning

confidence: 97%

Rapidly rule out acute myocardial infarction by combining copeptin and heart-type fatty acid-binding protein with cardiac troponin

et al. 2015

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“…The availability of a validated CDR, incorporating a PoCT measuring a biomarker of myocardial damage (eg, high-sensitive troponin (hsTn) or heart-type fatty acid binding protein (H-FABP)) is anticipated, however not yet available (Nilsson et al, 2013;Glatz and Mohren, 2013;Glatz and Renneberg, 2014;Willemsen et al, 2014Willemsen et al, , 2015. The majority of GPs expect future PoCTs to be of added value in ruling out ACS (Kip et al, 2017).…”

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confidence: 99%

Early health technology assessment of future clinical decision rule aided triage of patients presenting with acute chest pain in primary care

Willemsen

Kip²,

Koffijberg³

et al. 2017

Prim Health Care Res Dev

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The objective of the paper is to estimate the number of patients presenting with chest pain suspected of acute coronary syndrome (ACS) in primary care and to calculate possible cost effects of a future clinical decision rule (CDR) incorporating a point-of-care test (PoCT) as compared with current practice. The annual incidence of chest pain, referrals and ACS in primary care was estimated based on a literature review and on a Dutch and Belgian registration study. A health economic model was developed to calculate the potential impact of a future CDR on costs and effects (ie, correct referral decisions), in several scenarios with varying correct referral decisions. One-way, two-way, and probabilistic sensitivity analyses were performed to test robustness of the model outcome to changes in input parameters. Annually, over one million patient contacts in primary care in the Netherlands concern chest pain. Currently, referral of eventual ACS negative patients (false positives, FPs) is estimated to cost €1,448 per FP patient, with total annual cost exceeding 165 million Euros in the Netherlands. Based on 'international data', at least a 29% reduction in FPs is required for the addition of a PoCT as part of a CDR to become cost-saving, and an additional €16 per chest pain patient (ie, 16.4 million Euros annually in the Netherlands) is saved for every further 10% relative decrease in FPs. Sensitivity analyses revealed that the model outcome was robust to changes in model inputs, with costs outcomes mainly driven by costs of FPs and costs of PoCT. If PoCT-aided triage of patients with chest pain in primary care could improve exclusion of ACS, this CDR could lead to a considerable reduction in annual healthcare costs as compared with current practice.

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“…It is a powerful regulator of the mitochondrial beta-oxidative system in the heart 9 . It was first noted to be a marker of myocardial infarction (MI) in 1988 [10][11] , it is rapidly released from the cytosol into the circulation after myocardial ischemia and necrosis 12 . H-FABP was shown to be associated with chronic heart failure patients 13 .…”

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confidence: 99%

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2017

IJPSR

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

Cited by 14 publications

References 13 publications

Rapidly rule out acute myocardial infarction by combining copeptin and heart-type fatty acid-binding protein with cardiac troponin

Rapidly rule out acute myocardial infarction by combining copeptin and heart-type fatty acid-binding protein with cardiac troponin

Early health technology assessment of future clinical decision rule aided triage of patients presenting with acute chest pain in primary care

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