Cardiac multi-marker strategy for effective diagnosis of acute myocardial infarction

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• 作者：Qin Xu ; Cangel P.Y. Chan ; Xiao-yao Cao ; Peng Peng ; Maisumu Mahemuti ; Qi Sun ; Kwan-yee Cheung ; Wai-sze Ip ; Xin-rong Zhou ; Ge-yang Hu ; Xiao-feng Zhang ; Jiasharete Jielile ; Yao-dong Li ; Rong Ren ; Jan F.C
• 关键词：Acute myocardial infarction (AMI) ; Cardiac troponin I (cTnI) ; Creatine kinase MB (CK-MB) ; Heart-type fatty acid-binding protein (H-FABP) ; Multi-marker
• 刊名：Clinica Chimica Acta
• 出版年：2010
• 出版时间：11 November 2010
• 年：2010
• 卷：411
• 期：21-22
• 页码：1781-1787
• 全文大小：435 K

文摘

Background

Heart-type fatty acid-binding protein (H-FABP) is a heart-specific and highly sensitive biomarker for early diagnosis of acute myocardial infarction (AMI). We investigated the effectiveness of H-FABP for diagnosis of AMI in patients with different ethnic background and different time from symptom onset.

Methods

Venous blood was withdrawn from consecutive patients with acute chest pain admitted to the First Affiliated Hospital of Xinjiang Medical University. The blood samples were used for measurement of creatine kinase MB (CK-MB) and cardiac troponin I (cTnI) using Beckman Coulter DC-800 analyzer, and detection of H-FABP using a one-step bedside immunotest.

Results

Two hundred and eighty-nine patients admitted within 12 h after the onset of symptoms were recruited in the study. The H-FABP immunotest was found to have higher diagnostic accuracy than cTnI and CK-MB in patients admitted within 3 h. The combination of H-FABP and cTnI was found to have the highest diagnostic accuracy (91 % ) among different cardiac markers and the other combinations. It gave the highest sensitivity [96 % (95 % CI: 91–98 % )] and a comparable specificity [84 % (95 % CI: 76–89 % )] to cTnI alone.

Conclusion

A cardiac panel consisting of H-FABP and troponin is recommended.