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THE VALUE OF HEART- FATTY ACID BINDING PROTEIN (H-FABP) IN THE EARLY DIAGNOSTIC OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Truong Xuan Le, Phuc Xuan Minh Le, Tram Thanh Nguyen, Thanh Minh Nguyen, Vinh Thanh Tran

Abstract

Background: Cardiac biomarkers play an important role in early diagnosis of Acute Myocardial Infraction (AMI) with high morbidity in the affected and a significant mortality rate in coronary artery disease patients in order to prevent major complications and death. Traditional cardiac markers such as CK (creatine kinase) – MB isoform (CK-MB), cardiac specific troponin I start to rise in blood stream too late. Hence the search for a novel biomarker for myocardial infarction (MI) which if highly specific and sensitive especially in the first few hours of MI is necessary.

Objectives: The main purpose of present study is to find the diagnostic value of Heart Type - Fatty Acid Binding Protein (H-FABP) in the diagnosis of AMI and comparison of its diagnostic accuracy with cardiac troponin I (cTnI) and CK-MB.

Materials and Methods: This prospective and cross-sectional study was performed at Cho Ray hospital HCMC from June 2017 to May 2018 with 216 subjects. In all of them, 179 diagnosed AMI patients were follow up and treatment at Emergency Deparment, Heart Surgery Deparment, Internal Cardiology Department, Cardiology intervention Department as well as 57 healthy subjects from Outpatient Department. H-FABP was analyzed with automated MindrayBS800M by Immunoturbidimetric assay. Also, analysis of CK-MB and Troponin I was done. In addition to, the diagnostic sensitivity, specificity, and receiver operating characteristic curve were evaluated and compared with CK-MB and troponin I.

Results: H-FABP was released to blood stream and reached the highest concentration in 6-12 hours after chest pain (169 ng/ml the sensitivity was 96,4%) and decreased gradually. The specificity of H-FABP was 100% and higher when compared to CK-MB and troponin I at any period of study time. Within 0-24h, the combination of H-FABP, CK-MB and troponin I together had the highest sensitivity (97,2%) and the specificity was 80,7%. The cut-off value of H-FABP of AMI patients in our study was 5,7 ng/ml with 90,5% for the sensitivity and 100% for the specificity. The area under the curve was observed to be 0.99 with 95% confidence interval, which was higher than CK-MB (0,92) and troponin I (0,86) within 0-24 h (p<0,001).

Conclusion: H-FABP can be used as an early diagnostic cardiac biomarker in the early detection of patients with AMI  within 12h. 

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