Prognostic Value of Serum Concentration of Heart-Type Fatty Acid–Binding Protein Relative to Cardiac Troponin T on Admission in the Early Hours of Acute Coronary Syndrome

Ishii, Junnichi; Ozaki, Yukio; Lu, Jingchao; Kitagawa, Fumihiko; Kuno, Takahiro; Nakano, Tadashi; Nakamura, Yoriyuki; Naruse, Hiroyuki; Mori, Yoshihide; Matsui, Shigeru; Oshima, Hisaji; Nomura, Masatoshi; K, Ezaki; Hishida, Hitoshi

doi:10.1373/clinchem.2004.047662

Cited by 68 publications

(38 citation statements)

References 23 publications

(17 reference statements)

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“…64 In patients with ACS, serum H-FABP is an independent predictor of cardiac events (cardiac death or nonfatal MI) on intermediate followup (12 months) and has a greater predictive capacity for cardiac events than cTnT. 66,67 H-FABP may also be used as a reliable marker for the evaluation of the severity of congestive HF. 68 Its levels have been positively correlated with BNP levels in patients with ADHF before and after treatment.…”

Section: Fabp In Cinmentioning

confidence: 99%

Early Biomarkers of Renal Injury

Cruz

Goh

Haase-Fielitz

et al. 2010

Congestive Heart Failure

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Congest Heart Fail. 2010;16(4)(suppl 1):S25–S31. ©2010 Wiley Periodicals, Inc.Cardiorenal syndrome (CRS) refers to pathophysiologic interaction of the heart and kidney and is associated with acute kidney injury (AKI) and high mortality. Cardiac surgery or acute decompensated heart failure and radiocontrast‐induced nephropathy are common clinical scenarios of CRS. Unfortunately, established functional biomarkers of glomerular filtration rate such as serum creatinine, urea, and diuresis delay AKI diagnosis by 24 to 48 hours. Novel renal biomarkers indicating tubular injury are emerging and may have wide implications. This review focuses on several novel renal biomarkers with the most promising biologic characteristics and clinical evidence for their AKI predictive ability: neutrophil gelatinase‐associated lipocalin, kidney injury molecule‐1, interleukin 18, and fatty acid–binding proteins. The value of each biomarker is reviewed on currently available clinical data in typical settings of CRS. These markers might extend the therapeutic window during which timely and individualized patient management might be possible.

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Section: Fabp In Cinmentioning

confidence: 99%

Early Biomarkers of Renal Injury

Cruz

Goh

Haase-Fielitz

et al. 2010

Congestive Heart Failure

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“…One earlier study with the use of the same technology demon strated a 100% sensitivity for H-FABP and higher AUC (0.998) at cut-point of 5.08 ng/mL within 6 hours from the onset of chest pain (10). On average, the sensi tivity of H-FABP assays for the early diagnosis of AMI reaches 90% at 5-6 ng/mL as cut-off value (6)(7)(8)11).…”

Section: Discussionmentioning

confidence: 93%

The Use of Biochip Cardiac Array Technology for Early Diagnosis of Acute Coronary Syndromes

Sypniewska¹,

Sawicki²,

Krintus³

et al. 2009

Journal of Medical Biochemistry

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Kratak sadr`aj: Troponin u serumu je najbolji biomarker za dijagnostikovanje akutnog koronarnog sindroma, ali do postavljanja definitivne dijagnoze prolazi dosta vremena. Cilj studije je da se ispita da li pristup s vi{e markera, pomo }u bio~ip metode omogu}ava rano dijgnostikovanje. Bio markeri u serumu odre|eni su prilikom prijema (≤6 asova) i posle 6 ~asova kod 42 pacijenata sa simptomima akutnog koronarnog sindroma. Sr~ani troponin I izmeren je osetljivim testom (STATcTnI) dok su sr~ani markeri (H-FABP, mioglobin, cTnI, maseni CK-MB, karbo-anhi draza III) odre|eni pomo}u tehnologije »Biochip Array«. Koncen tracije dobijene pomo}u STATcTnI u prvih 6 ~asova bile su povi{ene >99 procenata u odnosu na referentnu populaciju kod 83,3% ispitanika, ali ni kod koga nisu pre{le »cut-off« vrednost za akutni infarkt miokarda. Prilikom prijema samo je marker H-FABP imao senzitivnost od 90,5% u svim slu~ajevima akutnih koronarnih sindroma i senzitivnost od 100% kod pacijenata sa STEMI/NSTEMI. Osetljivost mio globina na prijemu bila je 71,4% za AKS, me|utim, osetljivost kombinacije mioglobina i H-FABP dostigla je 95,2%. Sni`avanje »cut-off« vrednosti za cTnI omogu}ilo je rano dijagnostikovanje (≤6 ~asova) kod samo 26,2% pacijenata sa AKS i 95,2% posle slede}ih 6 ~asova. Kod nestabilne angine sr~ani panel nije bio dovoljno pre cizan za ranu stra tifikaciju rizika. Mo`e se zaklju~iti da testiranje oba markera -H-FABP i senzitivnog sr~anog tropo nina do stupno putem metode »Cardiac Array« -mo`e olak{ati ranu detekciju o{te}enja miokarda u klini~koj praksi.Klju~ne re~i: akutni koronarni sindromi, sr~ani biomarkeri, troponin, H-FABP Summary: Serum troponin is the best biomarker for the diagnosis of acute coronary syndrome, but it takes considerable time before a definitive diagnosis is available. The purpose of this study was to evaluate whether a multimarker approach, using the biochip cardiac array, would facilitate the early diagnosis. Serum biomarkers were determined on admission (≤6 hrs) and after 6 hours in 42 patients suspected for ACS. Cardiac troponin I was measured by a sensitive assay (STATcTnI) and cardiac markers (H-FABP, myoglobin, cTnI, CK-MB mass, carbonic anhydrase III) were assayed with the use of Biochip Array Technology. STATcTnI concentrations, within the first 6 hours, were elevated >99 th percentile for the reference population in 83.3% of subjects, but none reached the cutoff for AMI. On admission H-FABP was the only marker with 90.5% sensitivity in all ACS cases and 100% sensitivity in STEMI/NSTEMI patients. The sensitivity of myoglobin at presentation was 71.4% in ACS, however, combined sensitivity of myoglobin and H-FABP reached 95.2%. Lowering the cut-off for cTnI allowed early diagnosis (≤6 hrs) in only 26.2% of ACS patients and 95.2% after the next 6 hours. In unstable angina the cardiac panel was not sufficiently accurate for early risk stratification. In conclusion, testing for both markers, H-FABP and sensitive cardiac troponin, available with the cardiac array may facilitate the early detection...

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“…Importance of biomarkers, both in diagnosis and prognosis of ACS is now well established [2] and proved superior to electrocardiographic guidance alone [8]. Cardiac troponins remain the cornerstone in the risk stratification of patients with suspected ACS [14].…”

Section: Discussionmentioning

confidence: 99%

“…Heart-type fatty acidbinding protein (h-FABP) is a low molecular weight (14.5 kDa) protein, which contains 132 amino acid residues [7]. h-FABP is found in abundance in cardiomyocytes but is also expressed (to a lesser extent) in skeletal muscle, distal tubular cells of the kidney, specific parts of the brain, lactating mammary glands and placenta [8]. h-FABP binds two molecules of fatty acids and is involved in the delivery of fatty acyl coenzyme A, which is actively included in oxidation processes, which generate energy in the mitochondria.…”

Section: Introductionmentioning

confidence: 99%

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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Prognostic Value of Serum Concentration of Heart-Type Fatty Acid–Binding Protein Relative to Cardiac Troponin T on Admission in the Early Hours of Acute Coronary Syndrome

Cited by 68 publications

References 23 publications

Early Biomarkers of Renal Injury

Early Biomarkers of Renal Injury

The Use of Biochip Cardiac Array Technology for Early Diagnosis of Acute Coronary Syndromes

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

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