Publication:

Diagnostic utility of heart type fatty acid binding protein (H-FABP) versus cardiac troponin I in myocardial infarction

Background Acute myocardial infarction (AMI) management is one of the therapeutic challenges faced by the emergency physician. In the field of investigational cardiology advancements, the search of superior cardiac biomarkers has led to the discovery of sensitive biomarkers which help in the early confirmation of MI as timely intervention is the primary goal in acute coronary syndrome (ACS). Present study was aimed to evaluate the diagnostic performance of the novel biomarker H- FABP in patients with AMI especially in ST elevation MI (STEMI) and comparison of its diagnostic accuracy with the other biomarkers.

Methods We studied 66 patients with persistent STEMI presenting within 12 hours of symptom to the department of General Medicine, Sri Manakula Vinayagar Medical College and Hospital (SMVMCH), Puducherry. Quantitative and qualitative estimation and analysis of serum biomarkers of acute myocardial infarction such as CK-MB, cardiac Troponin I (cTnI) and H-FABP were done.

Results The sensitivity and specificity of H-FABP were 80.7 and 88.9% respectively. The positive percentage of the serum biomarkers among these patients were 64%, 65%, 86% for CK-MB, cardiac troponin I, and H-FABP respectively. The area under the curve was observed to be 0.695, with 95% confidence interval (0.514-0.876) at the optimum cut-off value of 7.0ng/ml for H-FABP.

Conclusions H-FABP the novel biomarker, because of its early appearance in the blood stream and due to its superior sensitivity and specificity compared to Troponin I and CK-MB can be used in the early diagnosis of acute ST elevation Myocardial Infarction.