The Value Of The Heart-Type Fatty Acid Binding Protein In Early Diagnosis Of Acute Myocardial Infarction

BackgroundAcute myocardial infarction (AMI) is a serious cardiovascular disease,early diagnosis and immediate reperfusion therapy may reduce the mortality and improve prognosis in patients with AMI.At present,the diagnosis of AMI is amainly based on the clinical manifestations,laboratory examination results and ECG changes, but there are many limitations of these methods. Heart-type fatty acid binding protein (H-FABP) is a novel biomarker of myocardial injuries,it has been reported that there are higher sensitivity of H-FABP detection than that of the traditional biomarkers in the early diagnosis of AMI.ObjectiveTo invastigate the value of H-FABP in early diagnosis of acute myocardial infarction.Methods110 patients admited in hospital with acute chest pain were enrolled in this study.The patients were divided into three groups according to the onset time of chest pain:<3h, 3-6h and after 6h, Serum H-FABP,CK-MB,cTnI levels were detected immediately after admission.The sensitivity,specificity,positive predictive value,nagative predictive value,an- d dignosistic accuracity in the diagnosis of AMI were compared among these three biomarkers in different admission times.The sensitivty and specificity in the diagnosis of AMI of combinated detetion of H-FABP and cTnI were compared with that of cTnI and CK-MB.Results1.The sensitivity of H-FABP in the diagnosis of AMI was 87.5% ,It was significantly higher than that of CK-MB(9.1%, P<0.05) and (cTnI 45.8%, P<0.05) in patients with chest pain onset within 3 hours;The specifivity of H-FABP in the diagnosis of AMI was 83.3%, CK-MB and cTnI 91.6%,there were no significant statistical difference among these three biomarkers(P>0.05). 2.The sensitivity of H-FABP in the diagnosis of AMI was 98.1% ,It was significantly higher than that of CK-MB(54.5%, P<0.05) and cTnI(63.6%, P<0.05) in patients with chest pain onset within 3-6 hours;The specifivity of H-FABP,CK-MB and cTnI was 94.4%,88.9% and 93.7% respectively,there were no significant statistical difference among these three biomarkers(P>0.05).3.The sensitivity of H-FABP in the diagnosis of AMI was 81.3% ,CK-MB93.7%, cTnI75%,in patients with chest pain attack in move than 6 hours;The specifivity of H-FABP,CK-MB and cTnI was 83.3%,94.4% and 100% respectively,there were no significant statistical difference of sensitivity among these three biomarkers(P>0.05).4.There were no significant statistical difference in positive predictive value among these three biomarkers in the diagnosis of AMI (P>0.05).The negative predictive value and dignositic accuracity of H-FABP in the diagnosis of AMI was 76.9%,86.1%,It was significantly higher than that of CK-MB(45.8%,61.1%,P<0.05) and (cTnI 33.3%, 36.1%, P < 0.05 ) in patients with chest pain onset within 3 hours.5.The sensitivity of H-FABP and cTnI combination detection was 93.5%,it was higher than that of cTnI and CK-MB(74.1%,P<0.05) in patient with chest pain attack within 6 hours,but there was no significant statistical difference in specificity(74.1%vs87.5%, P> 0.05).ConclusionsH-FABP as a novel biomarker of acute myocardial injury,is more sensitive in the early diagnosis of AMI than the traditional parameters such as cTnI and CK–MB;Combi- nation detection of H-FABP and cTnI can increase the sensitivity in patient with chest pain attack within 6 hours.