Table of Contents
Journal of Biomarkers
Volume 2014, Article ID 624930, 9 pages
http://dx.doi.org/10.1155/2014/624930
Research Article

Diagnosis of Non-ST-Elevation Acute Coronary Syndrome by the Measurement of Heart-Type Fatty Acid Binding Protein in Serum: A Prospective Case Control Study

1Department of Biochemistry, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh 500082, India
2Department of Cardiology, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh 500082, India

Received 30 September 2013; Revised 18 December 2013; Accepted 19 December 2013; Published 5 February 2014

Academic Editor: Valeria Matranga

Copyright © 2014 Priscilla Abraham Chandran et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A prospective case control study was undertaken to evaluate the diagnostic performance of serum heart-type fatty acid binding protein (HFABP) in comparison to cardiac TnT and TnI in 33 patients admitted with chest pain, diagnosed as NSTE-ACS (non ST elevation acute coronary syndrome) and 22 healthy controls. Area under the receiver operating curve (AUC) was highest for H-FABP (AUC 0.79; 95% CI 0.66–0.89) versus cTnI (AUC 0.73; 95% CI 0.59–0.84) and cTnT (AUC 0.71; 95% CI 0.57–0.83). The H-FABP level above 6.5 ng/mL showed 56.7% (CI 37.4–74.5) sensitivity, 0.5 (95% CI 0.3–0.7) negative likelihood ratio (−LR), 100% (CI 84.6–100.0) specificity, and 100% (CI 79.4–100.0) positive predictive value (PPV), 62.9% (CI 44.9–78.5) negative predictive value (NPV). cTnI level above 0.009 μg/L had 40% (CI 22.7–59.4) sensitivity, 0.6 (95% CI 0.4–0.8) −LR, 100% (CI 84.6–100.0) specificity, 100% (CI 73.5–100.0) PPV, and 55% (CI 38.5–70.7) NPV. cTnT showed 46.7% (CI 28.3–65.7) sensitivity, 0.5 (95% CI 0.4–0.7) −LR, 100% (CI 84.6–100.0) specificity, 100% (CI 76.8–100.0) PPV, and 57.9% (CI 40.8–73.7) NPV at level above 9 μg/L. +LR were 12.5 (95% CI 1.8–86.8), 1.7 (95% CI 1.0–3.0), and 1.2 (95% CI 0.8–1.9) for H-FABP, cTnI, and cTnT respectively. In conclusion measurement of H-FABP is a valuable tool in the early diagnosis of patients with chest pain (6–8 hrs) and seems to be a preferred biomarker in the differential diagnosis of NSTE-ACS. More studies are needed to determine whether serum H-FABP further improves diagnostic performance.