Serum concentrations of myoglobin vs human heart-type cytoplasmic fatty acid-binding protein in early detection of acute myocardial infarction

Abstract

We compared the diagnostic utility of serum concentrations of human heart-type cytoplasmic fatty acid-binding protein (H-FABPc), myoglobin, and their ratio for the early diagnosis of acute myocardial infarction (AMI) in 104 healthy volunteers and 165 patients at admission within 6 h of the onset of chest pain. The ROC curves of the H-FABPc [0.946, 95% confidence interval (CI) = 0.913–0.979] and myoglobin (0.895, 95% CI = 0.846–0.944) between patients with AMI and healthy volunteers were significantly greater than the area under the ratio of myoglobin to H-FABPc (0.823, 95% CI = 0.765–0.881). In 165 patients, the sensitivity (81.8%, 95% CI = 74.2–89.4%), specificity (86.4%, 95% CI = 78.1–94.6%), and predictive accuracy (83.6%, 95% CI = 78.0–89.3%) of H-FABPc >12 μg/L in diagnosing AMI were significantly higher than those of myoglobin, and were similar to those of the combination of H-FABPc >12 μg/L and the ratio ≤14. We conclude that H-FABPc is a more sensitive and specific marker than myoglobin for the early diagnosis of AMI, and that their ratio cannot give a clear advantage over the measurement of H-FABPc alone.

Biochemical markers of myocardial injury

“…It was found to be elevated within 3 hours after AMI and return to normal levels within 12-24 hours. Hence it is considered as a sensitive and specific marker of early detection of myocardial injury as compared to CKMB and / or DHBDH and myoglobin (70)(71)(72). Infact, it has been shown to be the earliest marker for confirmation and exclusion of AMI (73,74).…”

Biomarkers for Heart Failure

“…Heart‐type fatty acid binding proteins are low molecular weight (15 kd) cytoplasmic proteins found in myocardial cells 16–18 . These proteins have been implicated in facilitating the cellular uptake and intracellular transport of fatty acids for metabolic use 19 .…”

Assessing the Performance of a Novel Point-of-Care Qualitative Assay for Early Diagnosis of Acute Coronary Syndrome

“…Another cardiac biomarker, H-FABP, is a low molecular-weight protein that behaves similarly to myoglobin in terms of its kinetics and release [9]. However, in contrast to myoglobin, there is more fatty acid-binding protein in heart than in skeletal muscle, potentially making it a more cardiac-specific test [10-12]. H-FABP appears in the blood within an hour of myocardial injury and its level peaks 5 h after the onset of a coronary event [13].…”