Cardiac multi-marker strategy for effective diagnosis of acute myocardial infarction.

BACKGROUND

Heart-type fatty acid-binding protein (H-FABP) is a heart-specific and highly sensitive biomarker for early diagnosis of acute myocardial infarction (AMI). We investigated the effectiveness of H-FABP for diagnosis of AMI in patients with different ethnic background and different time from symptom onset.

METHODS

Venous blood was withdrawn from consecutive patients with acute chest pain admitted to the First Affiliated Hospital of Xinjiang Medical University. The blood samples were used for measurement of creatine kinase MB (CK-MB) and cardiac troponin I (cTnI) using Beckman Coulter DC-800 analyzer, and detection of H-FABP using a one-step bedside immunotest.

RESULTS

Two hundred and eighty-nine patients admitted within 12h after the onset of symptoms were recruited in the study. The H-FABP immunotest was found to have higher diagnostic accuracy than cTnI and CK-MB in patients admitted within 3h. The combination of H-FABP and cTnI was found to have the highest diagnostic accuracy (91%) among different cardiac markers and the other combinations. It gave the highest sensitivity [96% (95% CI: 91-98%)] and a comparable specificity [84% (95% CI: 76-89%)] to cTnI alone.

CONCLUSION

A cardiac panel consisting of H-FABP and troponin is recommended.

2010 Elsevier B.V. All rights reserved.