The Diagnostic Efficacy Of The Rapid Heart-fatty Acid-binding Protein Test In Patients With Early Acute Myocardial Infarction

Background: Exploring a highly sensitive and easily measuring test kit for the diagnosis of early stage myocardial infarction has great clinical significance. A domestic rapid heart-fatty acid-binding protein (H-FABP) test has been successfully created, yet its efficacy for the diagnosis of early acute myocardial infarction (AMI) requires further investigation.Aim: To evaluate the efficacy of heart-type fatty-acid binding protein (H-FABP) for early diagnosis of AMI.Methods: 104 consecutive patients admitted to the hospital within 6h after the onset of chest pain were recruited to the study. A rapid test kit for qualitative determination of H-FABP was employed to detect the whole blood H-FABP level in all patients at the time of admission. Serum troponinT (cTnT), creatine kinase-myocardial band(CK-MB), and myoglobin(MYO) were also measured simultaneously. The recent diagnostic criterias were adopted for the diagnosis of ST- elevated myocardial infarction(STEMI), non ST- elevated myocardial infarction(NSTEMI), unstable angina pectoris(UAP) and stable angina pectoris(SAP). The sensitivities and specificities of all the cardiac markers were calculated refering to the standard diagnosis.Results: Among 104 recruited patients, 51 of them had a final diagnosis of AMI, 53 were excluded from AMI, among whom 17 were diagnosed as UAP, 16 as SAP, and 20 as non-cardiogenic chest pain. By comparing the results of the biochemical tests with the standard diagnosis, we found that the sensitivity of H-FABP,MYO,CK-MB and cTnT in diagnosis of AMI were 86.27%, 68.63%, 47.06% and 47.06% respectively. The sensitivity of H-FABP was significantly higher than that of MYO, CK-MB and cTnT (P<0.05 for all). In terms of specificity, the numbers are 84.90%, 84.90%, 96.23% and 98.11% respectively. The specificity of H-FABP was lower than cTnT(P<0.05), but there was no significant difference between H-FABP and that of MYO or CK-MB; Within 3 hours after the onset of symptome appearance, the respective sensitivity of H-FABP,MYO,CK-MB and cTnT in diagnosis of AMI was 79.17% ,58.33%, 37.50% and 33.33%;Within 3-6 hours, the respective sensitivity was 92.59%,77.78%,55.56% and 59.26% , Both of the two time stage, the sensitivities of H-FABP were significantly higher than CK-MB and cTnT(both P<0.05); Within 6 hours after the onset of chest pain, the sensitivity of H-FABP + cTnT was significantly higher than that of MYO+CK-MB + cTnT (92.16% vs 76.47%, P<0.05), but the differences between the specificity of the two were not statistically significant.Conclusion: The rapid qualitative H-FABP test kit has high efficacy in the diagnosis of AMI as early as within 6 hours of symptom onset. Combining H-FABP and cTnT provides higher sensitivity than the MYO,CK-MB and cTnT combination in the diagnosis of early AMI.