RESEARCH ON CONCENTRATION CHANGE OF H-FABP IN EARLY DIAGNOSIS OF ACUTE MYOCARDIAL INFARCTION

Abstract

Objective: To evaluate the change of H-FABP in patients with Acute Myocardial Infarction at the time of 6 hours previously and 24 hours afterwards. To identify the sensitivity, specificity, positive predictive and negative predictive values, H-FABP cutoff point in comparison with hs troponin T. Methods: prospective study on 84 patients with Acute Myocardial Infarction and 28 healthy volunteers at Da Nang Hospital. The study period lasts from March 2014 to June 2015. Results: The average age of the diseased group is 62.57 ± 12.91 and the control group is 55.43 ± 12.33; a higher percentage of men than women 3 times in the disease group, 2 times compared with women in the control group. Regarding change of H-FABP concentrations in Acute Myocardial Infarction: H-FABP increased within 30 minutes after the onset, increased rapidly in the duration from 0-6 hours, peaked after 6-12 hours with the average concentration of 245.13 ± 452.63 ng/ml and returned to normal state after 36 hours. Meanwhile, hs troponin T appeared slower in blood after 3-6 hours, peaked after 12-24 hours at a concentration of 4.52 ± 3.38 average ng/ml. H-FABP and hs troponin T concentrations had significant difference statistically between the intervals with p <0,05. According to the results of our study: cutoff point of H-FABP was 6.6 ng/ml, sensitivity 88.1%, specificity 82.1%; compared with hs troponin T, the cutoff point was 0.014 ng/ml, sensitivity 82.1%, specificity 96.4%. If combining H-FABP with hs troponin T, the sensitivity will increase to 92.6% and specificity of 82.1%. The sensitivity, specificity, positive predictive and negative predictive values of H-FABP and hs of troponin T in the duration of 0-3 hours, were 89.3%, 82.1%, 93.7%, 69.7% and 53.3 %, 89.3%, 84.3%, 64.1% respectively; in the duration of 3-6 hours were 91.7%, 83.3%, 83.3%, 88.5% and 83.3%, 91.7%, 90.6%, 84.6% respectively; so in the duration of 0-6 hours, the H-FABP sensitivity was higher than that of hs troponin T; If combining H-FABP and hs troponin T, the sensitivity would increase at all time, Specifically, within 0-3 hours, 3-6 hours, 3-12 hours, 12-24 hours, and > 36 hours the sensitive was 92.9%, 95.8%, 94.7%, 96.2%, 90.6%, 85.7% respectively. The area under the ROC curve point of H-FABP 0-3 hours is 0.921 and the hs troponin T was 0.918. Conclusion: The study asserted that H-FABP is a superior biomarker in terms of sensitivity, more superior to hs troponin T in diagnosing myocardial necrosis in the early phase of 0-6 hours, the golden hours of acute MI; which helps make important decisions on treatment methods, risk stratification and prognosis. Keywords: marker, H-FABP (Heart type Fatty Acid Binding Protein), hs troponin T (high sensitive troponin T), acute myocardial infarction.