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

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Abstract

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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References

  1. Morrow D, Cannon C, Jesse R, Newby L, Ravkilde J, Storrow A, et al. National Academy of Clinical Biochemistry laboratory medicine practice guidelines: clinical characteristics and utilization of biochemical markers in acute coronary syndromes. Circulation. 2007;115(13):e356–75.

    Article  PubMed  Google Scholar 

  2. Nagesh C, Roy A. Role of biomarkers in risk stratification of acute coronary syndrome. Indian J Med Res. 2010;132:627.

    PubMed Central  CAS  PubMed  Google Scholar 

  3. Body R, McDowell G, Carley S, Wibberley C, Ferguson J, Mackway-Jones K. A FABP-ulous ‘rule out’ strategy? Heart fatty acid binding protein and troponin for rapid exclusion of acute myocardial infarction. Resuscitation. 2011;82(8):1041–6.

    Article  PubMed  Google Scholar 

  4. Nusier M, Ababneh B. Diagnostic efficiency of creatine kinase (CK), CKMB, troponin T and troponin I in patients with suspected acute myocardial infarction. J Health Sci. 2006;52(2):180–5.

    Article  CAS  Google Scholar 

  5. Bass N. The cellular fatty acid binding proteins: aspects of structure, regulation, and function. Int Rev Cytol. 1988;111:143–84.

    Article  CAS  PubMed  Google Scholar 

  6. Viswanathan K, Hall A, Barth J. An evidence-based approach to the assessment of heart-type fatty acid binding protein in acute coronary syndrome. Clin Biochem Rev. 2012;33:3–11.

    PubMed Central  PubMed  Google Scholar 

  7. Ruzgar O, Bilge A, Bugra Z, Umman S, Yilmaz E, Ozben B, et al. The use of human heart-type fatty acid-binding protein as an early diagnostic biochemical marker of myocardial necrosis in patients with acute coronary syndrome, and its comparison with troponin-T and creatine kinase–myocardial band. Heart Vessels. 2006;21(5):309–14.

    Article  PubMed  Google Scholar 

  8. Ishii J, Ozaki Y, Lu J, Kitagawa F, Kuno T, Nakano T, et al. 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. Clin Chem. 2005;51(8):1397–404.

    Article  CAS  PubMed  Google Scholar 

  9. Colli A, Josa M, Pomar J, Mestres C, Gherli T. Heart fatty acid binding protein in the diagnosis of myocardial infarction: where do we stand today? Cardiology. 2007;108(1):4.

    Article  CAS  PubMed  Google Scholar 

  10. Gururajan P, Gurumurthy P, Nayar P, Rao GSN, Babu S, Cherian K. Heart fatty acid binding protein (H-FABP) as a diagnostic biomarker in patients with acute coronary syndrome. Heart Lung Circ. 2010;19(11):660–4.

    Article  CAS  PubMed  Google Scholar 

  11. Niizeki T, Takeishi Y, Takabatake N, Shibata Y, Konta T, Kato T, et al. Circulating levels of heart-type fatty acid-binding protein in a general Japanese population. Circ J. 2007;71(9):1452–7.

    Article  CAS  PubMed  Google Scholar 

  12. Slot MB, van der Heijden G, Rutten F, van der Spoel O, Mast E, Bredero A, et al. Heart-type fatty acid-binding protein in acute myocardial infarction evaluation (FAME): background and design of a diagnostic study in primary care. BMC Cardiovasc Disord. 2008;8(1):8.

    Article  Google Scholar 

  13. Mad P, Domanovits H, Fazelnia C, Stiassny K, Russmuller G, Cseh A, et al. Human heart-type fatty-acid-binding protein as a point-of-care test in the early diagnosis of acute myocardial infarction. QJM. 2007;100(4):203–10.

    Article  CAS  PubMed  Google Scholar 

  14. Viswanathan K, Kilcullen N, Morrell C, Thistlethwaite S, Sivananthan M, Hassan T, et al. Heart-type fatty acid-binding protein predicts long-term mortality and re-infarction in consecutive patients with suspected acute coronary syndrome who are troponin-negative. J Am Coll Cardiol. 2010;55(23):2590–8.

    Article  CAS  PubMed  Google Scholar 

  15. McMahon C, Lamont J, Curtin E, McConnell R, Crockard M, Kurth M, et al. Diagnostic accuracy of heart-type fatty acid–binding protein for the early diagnosis of acute myocardial infarction. Ame J Emerg Med. 2012;30(2):267–74.

    Article  Google Scholar 

  16. Haltern G, Peiniger S, Bufe A, Reiss G, Gülker H, Scheffold T. Comparison of usefulness of heart-type fatty acid binding protein versus cardiac troponin T for diagnosis of acute myocardial infarction. Am J Cardiol. 2010;105(1):1–9.

    Article  CAS  PubMed  Google Scholar 

  17. Nakata T, Hashimoto A, Hase M, Tsuchihashi K, Shimamoto K. Human heart-type fatty acid-binding protein as an early diagnostic and prognostic marker in acute coronary syndrome. Cardiology. 2003;99(2):96–104.

    Article  CAS  PubMed  Google Scholar 

  18. Ramaiah JH, Ramegowda TR, Ashalatha B, Ananthakrishna R, Nanjappa CM. Heart-type fatty acid-binding protein (h-fabp) as a novel biomarker for the early diagnosis of acute myocardial infarction in comparison with cardiac troponin T. J Evol Med Dent Sci. 2013;2(1):8–18.

    Article  CAS  Google Scholar 

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Acknowledgments

We acknowledge P. D Hinduja National Hospital & Medical Research Centre for their continued encouragement and Randox laboratories India Pvt. Ltd. for support in terms of reagents for the study.

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Correspondence to Tester F. Ashavaid.

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Reddy, L.L., Shah, S.A.V., Dherai, A.J. et al. Troponin T and Heart Type Fatty Acid Binding Protein (h-Fabp) as Biomarkers in Patients Presenting with Chest Pain. Ind J Clin Biochem 31, 87–92 (2016). https://doi.org/10.1007/s12291-015-0492-2

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  • DOI: https://doi.org/10.1007/s12291-015-0492-2

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