The role of heart-type fatty acid-binding protein in predicting properties of coronary atherosclerosis in patients with acute coronary syndrome

Abstract

Fatty acid-binding protein (FABP) is an independent predictor of cardiac events. However, the relation between increasing FABP and coronary atherosclerosis is unknown. We have investigated the relation between FABP and angiographic properties of coronary atherosclerosis in patients with acute coronary syndrome (ACS). The study population consisted of 93 patients with ACS (mean age: 56±10 years). Patients presenting to the emergency department within 2 h after onset of anginal symptoms were enrolled in the study. FABP was measured at second, fourth and sixth hours of chest pain. Cut-off FABP was accepted as 1.9 ng/ml. Coronary atherosclerosis was assessed with diseased vessel number (≥50 and ≥70% luminal narrowing), Gensini and extent scores. Median FABP-2 was 2.9 ng/ml (interquartile range: 1.6-10.4). Peak FABP was measured at fourth hour [median: 35.0 ng/ml (interquartile range: 2-77)]. There was a nonsignificant relation between angiographic findings and FABP-2. At fourth hour, Gensini, extent score and diseased vessel number were significantly higher above the cut-off level of FABP-4 (Gensini score: 3.7±3.4 vs. 6.2±3.4, P=0.005; extent score: 11.1±10 vs. 22.3±19.2, P=0.007; diseased vessel: 0.7±0.6 vs. 1.6±1.0, P=0.003, respectively). The sensitivity of FABP-2 for at least 50% lesion was 70%. The highest sensitivity was obtained at fourth hour (85% for ≥50% and 88% for ≥70% lesions). The sensitivity and positive predictive values for revascularization were 70 and 77% for FABP-2, 89 and 80% for FABP-4 and 89 and 81% for FABP-6. FABP levels are closely related with angiographic properties of patients with ACS. FABP may be an early and important marker for predicting the coronary anatomy and decision of treatment.