A Point-of-Care Immunotest for Bedside Determination of Heart-Type Fatty Acid-Binding Protein

Abstract

Heart-type fatty acid-binding protein (H-FABP) is a small cytosolic protein abundant in heart muscle cells. It offers great potential as a sensitive biomarker for early diagnosis of acute myocardial infarction (AMI). Ninety-one patients presented to the Emergency Department suspected of AMI with a median symptom onset of 6 h (IQR 3–20 h), of which 75 (82.4%) had AMI. The diagnostic performance of a point-of-care immunotest for H-FABP was compared with those of cardiac troponin T (cTnT), creatinine kinase MB (CK-MB), and myoglobin. The H-FABP immunotest was found to have a significant better sensitivity than the other markers and a better specificity than myoglobin and CK-MB. The H-FABP Immunotest gave the greatest area under the receiver operating characteristic (ROC) curve (0.864) for those admitted within 6 h after the onset of symptoms; whereas, cTnT gave the greatest area under the ROC curve (0.936) for those admitted 6–24 h. The H-FABP was also found to be the most efficient marker to diagnose patients suspected of AMI without ST-elevation and with a negative cTnT. Early detection of H-FABP using the point-of-care immunotest in patients suspected of AMI may allow more accurate targeting of appropriate therapy and considerable cost savings than the current diagnostic tests.