Comparative study of high sensitivity troponin T and heart-type fatty acid-binding protein in STEMI patients

Abstract

Aim and backgroundHeart-type fatty acid-binding proteins (H-FABP) which are detected within 2–3h of acute myocardial infarction are involved in uptake of free fatty acids in the myocardium. Our aim in the present study is to compare window periods of H-FABP to high sensitivity troponin T (hs-Trop T) in acute ST elevation myocardial infarction (STEMI). Methods160 STEMI diagnosed patient’s serum samples are analyzed for hs-Trop T and H-FABP. Different window periods of chest pain onset (<3h, 3–6h and >6h) are compared with complications, in-hospital mortality and statistically analyzed. ResultsFrom 160 patients, 53 (33%) cases are presented in <3h, 75 (47%) in 3–6, and 32 (20%) after >6h respectively. Accordingly sensitivity of hs-Trop T was 92%, 94% and 97% while H-FABP was 75%, 88% and 84%, respectively. Overall sensitivity was 94% and 82% respectively. Statistically significant difference between mean hs-Trop T values with respect to window period <3, 3–6 and >6h was 0.21, 0.35 and 0.80ng/ml respectively, p value<0.0001. No significant difference in H-FABP values was observed.Hs-Trop T positively correlated with age (r=0.153, P=0.05), window period (r=0.363, P<0.0001), TIMI score (r=0.208, P=0.008), ejection fraction (r=0.191, P=0.008), serum H-FABP (r=0.229, P=0.004), and serum hs-CRP (r=0.326, p<0.001). There was a statistically significant difference of mean hs-Trop T values with or without in hospital mortality (0.35 vs. 0.85ng/ml, respectively, p=0.008).No significant correlation to age, TIMI score, ejection fraction and hs-CRP values for H-FABP was observed. ConclusionIt appears that hs-Trop T is a more sensitive marker than H-FABP in early hours of AMI and higher hs-Trop T predicts increase in-hospital mortality.