Quantitative analysis of heart type fatty acid binding protein in early detection of acute coronary syndrome

Abstract

Background: Coronary heart disease is a major cause of mortality, morbidity and disability in developed countries. Even though coronary heart disease mortality rates worldwide have reduced over the past five decades, coronary heart disease is the major cause of death in one-third of people more than 35 years of age.Many risk factors and biomarkers have been studied in the past and research is on in detecting the acute coronary syndrome at the earliest so that reperfusion therapy can be undertaken as early as possible to save the life of patients. Heart-type fatty acid binding protein is a newer modality of investigation developed for the above purpose.Methods: Single centre cross-sectional observational study was conducted from 1 September 2017 to May 2019 with an aim to study novel cardiac biomarker h-FABP in patients with acute coronary syndrome and compare sensitivity and specificity of the same with that of troponin -T in the early detection of acute coronary events after fulfilling inclusion and exclusion criteria .The data of 80 patients were collected after getting informed consent. The clinical, demographic and investigations were performed as per the hospital protocol and such patients were recorded in the proforma. The additional test heart-type fatty acid binding protein is performed in the triage by collecting patient’s serum and by using point of care analysis machine. Statistical analysis was performed using SPSS version 20.0 and results were obtainedResults: Out of 80 patients selected males were 35 and female are 45. Chest pain was present in 58 people, dyspnoea was in 28, sweating in 40 people, 35 had anterior wall MI, 30 had Inferior wall MI and 15 had global hypokinesia. Median values of h-FABP values were 82 ng/dl, 53.2 ng/dl, 35.3 ng/dl at 0-6 hours, 6-12 hours, and 12-24 hours respectively after the onset of symptoms with a significant p< 0.001. There were major differences between median values between different time groups of symptoms onset. Median troponin T values were 0.061 ng/ml, 0.350 ng/ml, 1.56 ng/ml after 0-6 hours, 6-12 hours and 12-24 hours of onset of symptoms respectively. There was no correlation between h-FABP and troponin-T values.Conclusions: h-FABP rises early in coronary events in first 6 hrs of onset of symptoms of ACS serum levels of h-FABP decreases as time progresses in 24 hours. In comparison troponin-t levels continue to rise as time progresses. h-FABP serum levels can be used as novel marker for early detection of ACS.