The Diagnostic Value Analysis Of H-FAVP In Acute Myocardial Infarction

Objective:Through the detection of acute myocardial infarction (acute myocardial infarction, AMI) in patients with early onset of serum heart-type fatty acid binding protein (Heart-type Fatty Acid Binding Protein, H-FABP) and troponin I (cardiac troponin I, cTnI) of the dynamic changes of expression of AMI, differences between different time of onset of H-FABP, cTnI, diagnostic value of two markers in AMI, understanding the relationship between the early diagnosis of H-FABP, cTnI and AMI, and on H-FABP, cTnI on AMI value in early diagnosis.Abnormal increase of current clinical mainly myocardial necrosis markers as the foundation, then to make diagnosis of AMI combined with dynamic changes in patients with chest pain symptoms and electrocardiogram. At present the common clinical cardiac markers, such as troponin, generally in more than6hours to the myocardial infarction in blood increased significantly, its sensitivity is not high, although has the very high specificity, still unable to make early diagnosis of patients with AMI. Myoglobin although high sensitivity, but because cannot distinguish the increased concentration in the blood is from cardiac or skeletal muscle, so its specificity is not enough, not enough to make the correct diagnosis of AMI. In view of the above situation, lacking of a biochemical marker is sensitive and high specificity to diagnosis on AMI. H-FABP is a highly specific low molecular weight cytoplasmic protein, the gene is located on1p32-lp33, composed of132amino acid residues, with a molecular weight of14500, a valine residue a acetylation in its N terminal, its isoelectric point (PI) was5.1. There are reports that can be used for early diagnosis of AMI, but for the quantitative determination of time consuming, therefore has important clinical significance of qualitative detection.Methods:118patients with ACS (89with acute myocardial infarction,29without acute myocardial infarction) who were hospitalized after the onset of chest pain were enrolled. The AMI patients with chest pain onset to treatment time were divided into3hours group、3-6hours group and after6h group.Admit instantly qualitative determination of H-FABP and quantitative determination of cTnI and CK-MB, and statistical analysis of AMI diagnostic sensitivity, specificity, negative predictive value, and positive predictive value in different time periods.Results:In3hours of AMI onset, the H-FABP diagnostic sensitivity (66.67%) was higher than cTnI and CK-MB; specificity (88.89%) was significantly higher than the cTnI (P<0.05) and was no significant different from cTnI and CK-MB. The accuracy, positive predictive value and negative predictive value has no statistical significance (P>0.05). In3-6hours of AMI onset, the H-FABP diagnostic sensitivity (91.67%) was higher than cTnI and CK-MB; the difference between them has statistical significance (P<0.05). The specificity (91.67%) was significantly higher than the cTnI (P<0.05) and was no significant different from cTnI and CK-MB. The accuracy, positive predictive value and negative predictive value has no statistical significance (P>0.05). In after6hours of AMI onset, the H-FABP diagnostic sensitivity (70.00%) was no significant different from cTnI and CK-MB; the difference between them has no statistical significance (P>0.05). The specificity (50.00%) was significantly lower than the cTnI (P<0.05) and was no significant different from cTnI and CK-MB. the difference between them has no statistical significance (P>0.05).Conclusions:As new markers of myocardial necrosis, H-FABP has high sensitivity and specificity for the diagnosis of AMI. With six hours of the onset of AMI, the diagnostic performance of H-FABP was better than cTnI, and the diagnostic performance was staggering in3-6hours of the onset.