Prognostic value of serum concentration of heart-type fatty acid-binding protein relative to cardiac troponin T on admission in the early hours of acute coronary syndrome

Junnichi Ishii, Yukio Ozaki, Jingchao Lu, Fumihiko Kitagawa, Takahiro Kuno, Tadashi Nakano, Yuu Nakamura, Hiroyuki Naruse, Yoshihisa Mori, Shigeru Matsui, Hisaji Oshima, Masanori Nomura, Kouji Ezaki, Hitoshi Hishida

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Abstract

Background: Heart-type fatty acid-binding protein (H-FABP) is proposed as an early biomarker for acute myocardial infarction (AMI), but its prognostic value is unclear in acute coronary syndrome (ACS). We evaluated the prognostic value of the H-FABP concentration relative to cardiac troponin T (cTnT) in the early hours of ACS. Methods: Serum concentrations of H-FABP and cTnT were measured on admission in 328 consecutive patients hospitalized for ACS within 6 h after the onset of chest pain [AMI, 241 (73.5%) patients; ST-segment elevation myocardial infarction, 154 (47.0%) patients; and emergent coronary angiography within 24 h after admission, 287 (87.5%) patients]. Cardiac events, which were defined as cardiac death or subsequent nonfatal AMI, were monitored for 6 months after admission. Results: During the 6-month follow-up period, there were 25 cardiac events, including 15 cardiac deaths and 10 subsequent nonfatal AMIs. Stepwise multivariate analyses including clinical, electrocardiographic, and biochemical variables revealed that increased H-FABP (above the median of 9.8 μg/L), but not increased cTnT (above the median of 0.02 μg/L), was independently associated with cardiac events in all patients [relative risk (RR) = 8.96; P = 0.0004], the subgroup of patients with ST-segment elevation myocardial infarction (RR = 11.3; P = 0.02), and the subgroup of patients with unstable angina and non-ST-segment elevation myocardial infarction (RR = 8.31; P = 0.007). The area under the ROC curve was higher for H-FABP than for cTnT (0.711 vs 0.578; P = 0.08), suggesting that H-FABP concentrations have a greater predictive capacity for cardiac events than cTnT. Conclusion: Serum H-FABP is a potential independent predictor of cardiac events within 6 months of patient admission and may provide prognostic information superior to cTnT in the early hours of ACS.

Original languageEnglish
Pages (from-to)1397-1404
Number of pages8
JournalClinical Chemistry
Volume51
Issue number8
DOIs
Publication statusPublished - 01-08-2005

All Science Journal Classification (ASJC) codes

  • Clinical Biochemistry
  • Biochemistry, medical

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    Ishii, J., Ozaki, Y., Lu, J., Kitagawa, F., Kuno, T., Nakano, T., Nakamura, Y., Naruse, H., Mori, Y., Matsui, S., Oshima, H., Nomura, M., Ezaki, K., & Hishida, H. (2005). Prognostic value of serum concentration of heart-type fatty acid-binding protein relative to cardiac troponin T on admission in the early hours of acute coronary syndrome. Clinical Chemistry, 51(8), 1397-1404. https://doi.org/10.1373/clinchem.2004.047662