Prognostic value of combination of heart‐type fatty acid‐binding protein and ischemia‐modified albumin in patients with acute coronary syndromes and normal troponin T values

Liyan, Cui; Zhang, Jie; Hu, Xiaozhou

doi:10.1002/jcla.20276

Cited by 21 publications

(18 citation statements)

References 26 publications

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“…44 Sensitivity and specificity of these tests were, respectively, 89.0 and 80.8% for IMA, 82.9 and 80.8% for h-FABP, and 96.3 and 80.8% for the combination of IMA and h-FABP. The authors selected 108 patients with chest pain over 1 year in an ED of a university hospital in Beijing, China.…”

Section: Discussionmentioning

confidence: 91%

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Clinical Assessment of Ischemia‐modified Albumin and Heart Fatty Acid–binding Protein in the Early Diagnosis of Non‐ST‐elevation Acute Coronary Syndrome in the Emergency Department

Charpentier

Ducassé

Cournot

et al. 2010

Academic Emergency Medicine

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Objectives: Heart fatty acid-binding protein (h-FABP) and ischemia-modified albumin (IMA) have recently been evaluated, but to the best of our knowledge, no study has reported an analysis of these two markers for the detection of early myocardial infarction and myocardial ischemia in a large cohort of consecutive patients presenting to an emergency department (ED). This study evaluates the diagnostic accuracy and the clinical utility of h-FABP and IMA for non-ST-segment elevation acute coronary syndrome (ACS) diagnosis in the first hour of management in an ED.Methods: In a prospective 11-month study, 677 patients admitted to the ED with chest pain and suspected non-ST-segment elevation ACS were enrolled. On presentation, blood samples were obtained for the measurement of the biomarkers h-FABP (immunodetection with CardioDetect) and IMA (albumin cobalt-binding test). Two physicians, blinded to the results of the markers, independently categorized patients as having or not having non-ST-segment elevation ACS.Results: Of the 677 patients who were prospectively recruited, non-ST-segment elevation ACS was diagnosed in 185 (27.3%). While IMA was not predictive of the ACS diagnosis (odds ratio [OR] = 1.23; 95% CI = 0.87 to 1.81), h-FABP was predictive of ACS diagnosis (OR = 4.65; 95% CI = 2.39 to 9.04) with specificity at 96.8% (95% CI = 95.4% to 98.1%) and sensitivity at 13.5% (95% CI = 10.9% to 16.1%). However, h-FABP did not add significant additional information to a predictive model that included the usual diagnostic tools for non-ST-elevation ACS management (p = 0.40). Conclusions:In this study on a large cohort of patients admitted to an ED for chest pain, IMA and h-FABP did not provide valuable information for ACS diagnosis.

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Section: Discussionmentioning

confidence: 91%

“…The authors selected 108 patients with chest pain over 1 year in an ED of a university hospital in Beijing, China. 44 Every patient underwent coronary angiography: 52.7% had ‡70% stenosis, and 6.5% had 50% stenosis. Eighty-two patients were classified in the ACS group.…”

Section: Discussionmentioning

confidence: 99%

Clinical Assessment of Ischemia‐modified Albumin and Heart Fatty Acid–binding Protein in the Early Diagnosis of Non‐ST‐elevation Acute Coronary Syndrome in the Emergency Department

Charpentier

Ducassé

Cournot

et al. 2010

Academic Emergency Medicine

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“…As a result, this condition may lead to an enhancement in the plasma level of H-FABP. Previous studies have indicated that H-FABP is not only an early and sensitive marker for detecting myocardial damage in ACS (4-8) but also high in patients with ACS whose cTnT levels were normal 12 hour after the onset of symptoms (24). It was also noted that membrane permeability increases due to severe myocardial ischemia might cause H-FABP molecules, ample in cytoplasm, to be released into plasma (24).…”

Section: Discussionmentioning

confidence: 99%

Relationship between heart-type fatty acid-binding protein levels and coronary artery disease in exercise stress testing: an observational study

Arı¹,

Tokaç²,

Alihanoğlu³

et al. 2011

Anadolu Kardiyol Derg

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Objective: Although, there has been great improvement on the diagnosis and early treatment of acute coronary syndromes, especially in terms of myocardial damage biochemical markers, we do not have a specific marker yet, for using the diagnosis of stable coronary artery disease (CAD). This study aimed to evaluate the relationship between CAD and the changes of heart-type fatty acid binding protein (H-FABP) levels before and after exercise stress testing (EST). Methods: A total of 47 patients were enrolled in this observational study. Of 47 patients, 21 had normal coronary anatomy; the remaining 26 patients had coronary lesions over 70% in at least one major coronary artery. All patients performed EST. Along with this, H-FABP levels before EST and at peak exercise, 1 st hour, 3 rd hour (3h), were measured in all patients. Differences among the measurements were evaluated through the Friedman test and Wilcoxon test, and the Bonferroni correction was applied to determine which measurement caused the difference. Results: Contrary to expectations, the means of the H-FABP values measured at particular intervals for each group tended to decline from the basal level to the 3h level. When the difference between the 3h measurement and the basal level was compared in each group, the decreasing was statistically significant in both groups (p<0.05). A statistically significant decrease at the 3h measurement compared to the basal level in the CAD group was more apparent than in the control group (2.790±2.569ng/ml vs. 0.837±2.070ng/ml, p=0.009). Conclusion: We found that H-FABP levels did not increase during EST and contrary to expectation, were inclined to decrease. We thought that decreasing H-FABP levels likely resulted from exercise-induced proteinuria. (Anadolu Kardiyol Derg 2011; 11: 685-91) Key words: Coronary artery disease, heart-type fatty acid binding protein, exercise stress testing 685 ÖZET Amaç: Akut koroner sendrom tanısı ve erken tedavisinde özellikle miyokardiyal hasar belirteçlerinde sağlanan ilerleme ile önemli bir mesafe alınmasına rağmen stabil koroner arter hastalığı (KAH) tanısında kullanılabilecek özel bir markır henüz yoktur. Bu çalışmada egzersiz stres testi (EST) öncesi ve sonrası H-FABP düzeylerindeki değişim ile koroner arter hastalığı arasındaki ilişki araştırılmıştır. Yöntemler: Gözlemsel çalışmamıza en az bir majör koroner arterinde %70 ve üzerinde darlığı olan 26 hasta ve koroner arterleri normal bulunan 21 hasta olmak üzere toplam 47 hasta alındı. Tüm hastalara EST yapıldı. Tüm hastalarda bazal, pik egzersiz, 1. saat ve 3. saatte H-FABP ölçümü yapıldı. Ölçümler arası farka Friedman Testi ile bakıldı, farkın hangi ölçümden kaynaklandığını bulmak için Bonferroni düzeltmeli Wilcoxon Testi kullanıldı. Bulgular: Her bir grupta belirlenen zaman aralığında ölçülen H-FABP değerleri ortalamaları beklenenin aksine bazaldan üçüncü saate azalma eğiliminde idi. Üçüncü saat ile bazal ölçümler arasındaki farklar (fark 3) grup içinde karşılaştırıldığında her iki grupta da azalma anlamlı idi (p<0.05). H...

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“…Recent studies have suggested that both the serum H-FABP and urinary L-FABP may detect ongoing myocardial damage involved in the progression of ACS and may be potentially useful in diagnosis and prognostication in patients with ACS. 64,65 The combination of H-FABP and ischemia-modified albumin measurement on admission has been shown to be highly sensitive and specific in risk stratifying ACS patients with normal cTnT levels. 64 In patients with ACS, serum H-FABP is an independent predictor of cardiac events (cardiac death or nonfatal MI) on intermediate followup (12 months) and has a greater predictive capacity for cardiac events than cTnT.…”

Section: Fabp In Cinmentioning

confidence: 99%

“…64,65 The combination of H-FABP and ischemia-modified albumin measurement on admission has been shown to be highly sensitive and specific in risk stratifying ACS patients with normal cTnT levels. 64 In patients with ACS, serum H-FABP is an independent predictor of cardiac events (cardiac death or nonfatal MI) on intermediate followup (12 months) and has a greater predictive capacity for cardiac events than cTnT. 66,67 H-FABP may also be used as a reliable marker for the evaluation of the severity of congestive HF.…”

Section: Fabp In Cinmentioning

confidence: 99%

Early Biomarkers of Renal Injury

Cruz

Goh

Haase-Fielitz

et al. 2010

Congestive Heart Failure

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Congest Heart Fail. 2010;16(4)(suppl 1):S25–S31. ©2010 Wiley Periodicals, Inc.Cardiorenal syndrome (CRS) refers to pathophysiologic interaction of the heart and kidney and is associated with acute kidney injury (AKI) and high mortality. Cardiac surgery or acute decompensated heart failure and radiocontrast‐induced nephropathy are common clinical scenarios of CRS. Unfortunately, established functional biomarkers of glomerular filtration rate such as serum creatinine, urea, and diuresis delay AKI diagnosis by 24 to 48 hours. Novel renal biomarkers indicating tubular injury are emerging and may have wide implications. This review focuses on several novel renal biomarkers with the most promising biologic characteristics and clinical evidence for their AKI predictive ability: neutrophil gelatinase‐associated lipocalin, kidney injury molecule‐1, interleukin 18, and fatty acid–binding proteins. The value of each biomarker is reviewed on currently available clinical data in typical settings of CRS. These markers might extend the therapeutic window during which timely and individualized patient management might be possible.

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Prognostic value of combination of heart‐type fatty acid‐binding protein and ischemia‐modified albumin in patients with acute coronary syndromes and normal troponin T values

Cited by 21 publications

References 26 publications

Clinical Assessment of Ischemia‐modified Albumin and Heart Fatty Acid–binding Protein in the Early Diagnosis of Non‐ST‐elevation Acute Coronary Syndrome in the Emergency Department

Clinical Assessment of Ischemia‐modified Albumin and Heart Fatty Acid–binding Protein in the Early Diagnosis of Non‐ST‐elevation Acute Coronary Syndrome in the Emergency Department

Relationship between heart-type fatty acid-binding protein levels and coronary artery disease in exercise stress testing: an observational study

Early Biomarkers of Renal Injury

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