Early Detection Of Myocardial Infarction Research Articles

Exosomal miRNA-21-5p and miRNA-21-3p as key biomarkers of myocardial infarction.

Coronary artery disease (CAD) is a debilitating condition that can lead to myocardial infarction (MI). Exosomal miRNAs (exo-miRNA) can be diagnostic biomarkers for detecting MI. Here, we conduct a study to evaluate the efficacy of exo-miRNA-21-5p/3p for early detection of MI. A total of 135 CAD patients and 150 healthy subjects participated in this study. Additionally, we randomly divided 26 male Wistar rats (12 weeks old) into two groups: control and induced MI. Angiographic images were used to identify patients and healthy individuals of all genders. In the following, serum exosomes were obtained, and exo-miRNA-21-5p/3p was measured by reverse-transcriptase polymerase chain reaction. We observed an upregulation of exo-miRNA-21-5p/3p in CAD patient and MI-induced animal groups compared to controls. Analysis of the ROC curves defined 82% and 88% of the participants' exo-miRNA-21-5p and exo-miRNA-21-3p diagnostic power, respectively, which in the animal model was 92 and 82. This study revealed that the mean expression levels of exo-miRNA-21-5p/3p were significantly increased in CAD patients and animal models of induced MI. Also, these results are associated with the atherogenic lipid profile of CAD patients, which may play an important role in the progression of the disease. Therefore, they can be considered as novel biomarkers.

Early detection of myocardial infarction with reference to baseline levels during health: impact on biological variation of high-sensitivity cardiac troponin.

A 78-year-old male was seen in the emergency department (ED) with chest pain. Fifteen months earlier, he had presented to the ED with shoulder and elbow pain. High-sensitivity cardiac troponin I (hs-cTnI) testing was conducted at that time, which produced normal results of 10 and 13ng/L (cutoff <48ng/L). During the current admission, his electrocardiogram was unremarkable, with a borderline prolonged PR interval noted. The patient's hs-cTnI results were 25, 47, and 254ng/L at 0, 1, and 7 hours, respectively. He was diagnosed with demand ischemia and admitted to the hospital. The detection of acute myocardial infarction in this case was made during the first sample collection (t=0), despite the fact that this result was well within the normal range.

Diagnostic Potential of miRNA-15a-5p for the Early Detection of Myocardial Infarction

Myocardial infarction (MI), also known as a heart attack, is caused by reduced or complete cessation of blood flow to the part of the myocardium. MicroRNAs (miRNAs) are key regulators in various cellular mechanisms and have the potential to be used as diagnostic markers in certain diseases such as MI, atherosclerosis, heart failure coronary artery disease, hypertrophy, and fibrosis. The present study was conducted to assess the early diagnostic potential of circulatory miRNA-15a-5p. By using bioinformatics tools, it was found that BCL2, an antiapoptotic gene, is the putative target of miRNA-15a-5p. The blood was collected from the 50 MI patients recruited in Lady Reading Hospital Peshawar. qRT-PCR analysis showed significantly upregulated miRNA-15a-5p in MI patients’ blood and isoproterenol-induced MI rats’ blood and tissue samples. The decreased level of the antiapoptotic gene, BCL2, was confirmed by qRT-PCR in the circulation of both MI patients and MI rat model. The toxic potential of isoproterenol for MI induction in rats was confirmed by disrupted heart tissue histology, increased reactive oxygen species (ROS) and decreased antioxidative enzymes such as superoxide dismutase (SOD), catalase (CAT), peroxidase (POD), reduced glutathione (GSH) and ascorbate peroxidase (APX) in rat serum and tissue homogenate samples. In serum samples, liver function tests, and lipid profiling showed elevated levels in the MI rat model. Concludingly, this study provides future insights for miRNA research that will advance the development of diagnostic markers for the early detection of MI in patients.

Myocardial Infarction Signs and Symptoms: Females vs. Males.

Cardiovascular disease is the number one killer of females in the United States today, and myocardial infarction (MI) plays a role in many of these deaths. Females also present with more "atypical" symptoms than males and appear to have differences in pathophysiology underlying their MIs. Despite both differences in symptomology and pathophysiology being present in females versus males, a possible link between the two has not been studied extensively. In this systematic review, we analyzed studies examining differences in symptoms and pathophysiology of MI in females and males and evaluated possible links between the two. A search was performed for sex differences in MI in the databases PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature) Complete, Biomedical Reference Collection: Comprehensive, Jisc Library Hub Discover, and Web of Science. Seventy-four articles were ultimately included in this systematic review. Typical symptoms for both ST-elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) such as chest, arm, or jaw pain were more common in both sexes, but females presented on average with more atypical symptoms such as nausea, vomiting, and shortness of breath. Females with MI also presented with more prodromal symptoms such as fatigue in days leading up to MI, had longer delays in presentation to the hospital after symptom onset, and were older with more comorbidities than males. Males on the other hand were more likely to have a silent or unrecognized MI, which concurs with their overall higher rate of MI. As they age, females have a decrease in antioxidative metabolites and worsened cardiac autonomic function than male. In addition, at all ages, females have less atherosclerotic burden than mles, have higher rates of MI not related to plaque rupture or erosion, and have increased microvasculature resistance when they have an MI. It has been proposed that this physiological difference is etiologic for the male-female difference in symptoms, but this has not been studied directly and is a promising area of future research. It is also possible that differences in pain tolerance between males and females may play a role in differing symptom recognition, but this has only been studied one time where females with higher pain thresholds were more likely to have unrecognized MI. Again, this is a promising area for future study for the early detection of MI. Finally, differences in symptoms for patients with different atherosclerotic burden and for patients with MI due to a cause other than plaque rupture or erosion has not been studied and are both promising avenues to improve detection and patient care in the future.

Near real-time single-beat myocardial infarction detection from single-lead electrocardiogram using Long Short-Term Memory Neural Network

This study proposes a novel Long Short-Term Memory Neural Network (LSTM) architecture for the diagnosis of myocardial infarctions from individual heartbeats of single-lead electrocardiograms (ECGs). The proposed model is trained using an unbiased patient split approach and validated using 10-fold cross-validation over 148 myocardial infarction and 52 Healthy Control patients from the Physikalisch-Technische Bundesanstalt diagnostic ECG Database to generate an inter-patient classifier. We further demonstrate why special care must be taken when generating the training and testing datasets by exploring the effects of various data-split techniques that could mask the occurrence of overfitting and produce misleadingly high testing metrics of the model's performance. A thorough assessment of these results is provided using several standard metrics for different data split methods to show their tendency to overfitting, data leakage, and bias introduced from previously seen heart beats during the training phase. The design achieves near real-time diagnosis of 40 ms while providing an accuracy of 89.56% (with a 95% Confidence Interval (CI) of ±2.79%), recall/sensitivity of 91.88% (±3.13% 95%CI), and a specificity of 80.81% (±9.62% 95%CI). The fast processing makes the model readily deployable on currently existing mobile devices and testing instruments. The achieved performance makes the proposed method a new research direction for attaining real-time and unbiased diagnosis. While, the modular architectural design of the LSTM network structure, which is amenable for the inclusion of other ECG leads, could serve as a platform for early detection of myocardial infarction and for the planning of early treatment(s).

Left ventricular function and clinical heart failure after myocardial infarction revascularized with percutaneous coronary intervention - comparison between STEMI and NSTEMI in modern practice

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Left ventricular systolic dysfunction (LVSD) is a common consequence of myocardial infarction (MI). Data from historic series identified LVSD in up to 60% of patients post-MI. However, in modern practice, with high-sensitivity cardiac biomarkers leading to early detection of MI and widespread use of early revascularization, the prevalence of LVSD in the acute phase of MI and its impact on subsequent clinical heart failure remains unknown. Purpose To ascertain the prevalence of LVSD on pre-discharge echocardiography and its impact on subsequent clinical heart failure after type 1 MI treated with percutaneous coronary intervention (PCI) in a UK tertiary cardiac centre. Methods A retrospective electronic patient records review of consecutive patients with type 1 MI treated with PCI between January 2016 - December 2017. Patients treated conservatively or with surgical revascularization were excluded. Results 1000 consecutive patients were identified and 948/1000 who had an inpatient echocardiogram prior to discharge were included in this analysis – 413 ST elevation MI (STEMI) and 535 non-ST elevation (NSTEMI). Median door to balloon time for STEMI was 42 minutes (IQR 28-79). Median time from symptom onset to intervention for NSTEMI was 3 days (IQR 1-6). LVSD was defined as left ventricular ejection fraction (LVEF) &amp;lt;50% on transthoracic echocardiogram carried out during the hospital episode. LVSD was significantly more prevalent in patients with STEMI compared to NSTEMI (37.4% vs 17.3%, p &amp;lt; 0.001). Median LVEF was significantly lower in the STEMI population (55%, IQR 45-60) compared to patients with NSTEMI (60%, IQR 54-65), p &amp;lt; 0.001. However, rates of clinical heart failure at index presentation with MI did not vary significantly between STEMI and NSTEMI patients (6.1% vs 4.9%, p = 0.414). In stepwise multivariate regression models: age, peak troponin and previous coronary artery bypass grafting were predictors of LVEF, whereas LVEF and previous MI were predictors of clinical heart failure Patients with LVSD on pre-discharge echocardiography had significantly higher rates of 30-day readmission with heart failure (2.9% vs 0.7%, p = 0.017), 30-day all-cause mortality (6.1% vs 2%, p = 0.001), 30-day cardiac mortality (5.7% vs 1%, p &amp;lt; 0.001) and 2-year all-cause mortality (5.7% vs 1.6%, p = 0.001). However, at 2-years, there was no difference in hospital readmission with heart failure (0.8% vs 0.3%, p = 0.276). There were no significant differences between STEMI and NSTEMI patients for these endpoints. Conclusions Early revascularisation with PCI has led to a reduction in the prevalence of early LVSD post-MI compared to historical data. However, the presence of LVSD remains a powerful predictor of adverse clinical outcomes. Despite lower rates of LVSD on pre-discharge echocardiography in patients with NSTEMI compared with STEMI, the incidence of subsequent clinical heart failure is similar. This however may be underestimated due to survival bias.

Early Detection of Myocardial Infarction in Low-Quality Echocardiography

Myocardial infarction (MI), or commonly known as heart attack, is a life-threatening health problem worldwide from which 32.4 million people suffer each year. Early diagnosis and treatment of MI are crucial to prevent further heart tissue damages or death. The earliest and most reliable sign of ischemia is regional wall motion abnormality (RWMA) of the affected part of the ventricular muscle. Echocardiography can easily, inexpensively, and non-invasively exhibit the RWMA. In this article, we introduce a three-phase approach for early MI detection in low-quality echocardiography: 1) segmentation of the entire left ventricle (LV) wall using a state-of-the-art deep learning model, 2) analysis of the segmented LV wall by feature engineering, and 3) early MI detection. The main contributions of this study are highly accurate segmentation of the LV wall from low-quality echocardiography, pseudo labeling approach for ground-truth formation of the unannotated LV wall, and the first public echocardiographic dataset (HMC-QU)* for MI detection. Furthermore, the outputs of the proposed approach can significantly help cardiologists for a better assessment of the LV wall characteristics. The proposed approach has achieved 95.72% sensitivity and 99.58% specificity for the LV wall segmentation, and 85.97% sensitivity, 74.03% specificity, and 86.85% precision for MI detection on the HMC-QU dataset. *The benchmark HMC-QU dataset is publicly shared at the repository https://www.kaggle.com/aysendegerli/hmcqu-dataset

Untiring Pursuit for Glucarate-Based Molecular Imaging Probes.

Glucarate, a physiologic end-product of the D-glucuronic acid pathway in mammals, is a six-carbon dicarboxylic acid with a wide range of uses. Glucarate-based molecular imaging probes including [99mTc]glucarate and [18F]glucarate have been developed and demonstrated to have infarct/necrosis-avid and/or tumor-seeking properties, showing potential applications in early detection of myocardial infarction, evaluation of tissue viability, monitoring of therapeutic effectiveness, and noninvasive imaging of certain tumors including drug-resistant ones. The mechanism by which [99mTc]glucarate localizes in acute necrotic tissues has been demonstrated to be largely attributable to its binding to the positively charged histones, which become accessible after the disruption of the cell and nuclear membranes as a result of irreversible damage, while the tumor-seeking mechanism of [99mTc]glucarate has been found to be closely related to glucose transporter 5 expression. Moreover, the recently developed [18F]glucarate provides a new alternative probe for positron emission tomography imaging and may have potential advantages over [99mTc]glucarate. In this review, we present the untiring pursuit for glucarate-based molecular imaging probes as infarct/necrosis-avid agent and/or tumor-seeking agent. Moreover, the limitations and the prospects for future research of glucarate-based molecular probes are also discussed.

Antibody Epitope and Affinity Determination of the Myocardial Infarction Marker Myoglobin by SPR-Biosensor Mass Spectrometry.

Myoglobin (MG) is a biomarker for heart muscle injury, making it a potential target protein for early detection of myocardial infarction. Elevated myoglobin levels alone have low specificity for acute myocardial infarction (AMI) but in combination with cardiac troponin T have been considered highly efficient diagnostic biomarkers. Myoglobin is a monomeric heme protein with a molecular weight of 17 kDa that is found in skeletal and cardiac tissue as an intracellular storage unit of oxygen. MG consists of eight α-helices connected by loops and a heme group responsible for oxygen-binding. Monoclonal antibodies are widely used analytical tools in biomedical research and have been employed for immunoanalytical detection of MG. However, the epitope(s) recognized by MG antibodies have been hitherto unknown. Precise molecular identification of the epitope(s) recognized by antibodies is of key importance for the development of MG as a diagnostic biomarker. The epitope of a monoclonal MG antibody was identified by proteolytic epitope extraction mass spectrometry in combination with surface plasmon resonance (SPR) biosensor analysis. The MG antibody was immobilized both on an affinity microcolumn and a gold SPR chip. The SPR kinetic analysis provided an affinity-binding constant KD of 270 nM for MG. Binding of a tryptic peptide mixture followed by elution of the epitope from the SPR-MS affinity interface by mild acidification provided a single-epitope peptide located at the C-terminus [146-153] [YKELGFQG] of MG. The specificity and affinity of the epitope were ascertained by synthesis and affinity-mass spectrometric characterization of the epitope peptide.

Blood pressure-related hypoalgesia: a systematic review and meta-analysis.

Spontaneous or experimentally induced high blood pressure (BP) is associated with reduced pain perception, known as BP-related hypoalgesia. Despite its clinical implications, such as the interference with early detection of myocardial infarction in 'at risk' groups, the size of the association between high BP and pain has not yet been quantified. Moreover, the distinct association between high BP and physiological or psychological components of pain has not yet been considered so far. The aim of this study was to overcome this gap by performing separate meta-analyses on nociceptive response versus quantifiable perceptual measures of pain in relation to high BP. PubMed and Web of Knowledge databases were searched for English language studies conducted in humans. Fifty-nine studies were eligible for the analyses. Pooled effect sizes (Hedges' g) were compared. Random effect models were used. Results show that higher BP is significantly associated with lower nociceptive response (g = 0.38; k = 6) and reduced pain perception, assessed by quantifiable measures (g = 0.48; k = 59). The association between BP and pain perception, derived from highly heterogeneous studies, was characterized by significant publication bias. BP assessment, pain assessment, site of pain stimulation, percentage of female participants in the sample, and control for potential confounders were significant moderators. Current meta-analytic results confirm the presence of BP-related hypoalgesia and point towards the need for a better understanding of its underlying mechanisms.

Automated Detection of Myocardial Infarction Using a Gramian Angular Field and Principal Component Analysis Network

Myocardial infarction (MI) is a deadly disease that threatens human life worldwide, and it is essential to save threatened lives with early detection of MI. The electrocardiogram (ECG), which records the electrical activity presented in the heart, is used for the prevention and treatment of heart disease such as MI. However, it remains a challenge to visually interpret the ECG signals because of their small amplitude and duration. Inspired by the development in computer vision, we try to explore a novel approach for automatic detection of MI by imaging ECG signals without noise removal. In this paper, the ECG time series is first transformed into images using the Gramian Angular Difference Field (GADF) method. Subsequently, the processed images are subjected to the principal component analysis network (PCANet) to extract sparse high-dimensional features, which are easy to perform well in linear classifiers. We carried out several sets of experiments to test the effectiveness of our algorithm. The overall accuracy of 99.49%, the sensitivity of 99.78%, and the specificity of 98.08% are achieved in class-oriented experiments using original ECG beats. The accuracy even rises over 1% compared with the denoising one; Moreover, we also achieved favorable performance for the patient-specific experiment (accuracy of 93.17%, sensitivity of 93.91%, and specificity of 89.20%). The results of the experiments indicate that our model is an effective way to detect MI using raw ECG signals.

A Cardiac Troponin T Biosensor Based on Aptamer Self-assembling on Gold.

In this study, a sensitive and accurate aptasensor was designed for early detection of myocardial infarction through the determination of troponin T (TnT). The successful immobilization of a specific aptamer sequence on the surface of gold that had a high affinity toward TnT was accomplished. TnT was electrochemically quantified. The results indicated that the aptasensor detected TnT in a range of 0.05-5 ng mL, and with a detection limit of 0.01 ng/mL. The performance of the aptasensor was investigated by analyzing 99 human serum samples. Both diagnostic specificity and sensitivity of the aptasensor were found to be 95%. The use of the designed aptamer-based biosensor could be an essential achievement in health policy, preventing deaths caused by myocardial infarction, and reducing patients with heart failure. The extensive use of this aptamer-based biosensor can also reduce costs, enhance speed, and improve accuracy in the diagnosis of TnT as an important myocardial infarction biomarker.

Automated Identification of Myocardial Infarction Using Harmonic Phase Distribution Pattern of ECG Data

Incorporation of automated electrocardiogram (ECG) analysis techniques in home monitoring applications can ensure early detection of myocardial infarction (MI), thus reducing the risk of mortality. Most of the published techniques use advanced signal processing tools, a huge number of ECG features, and complex classifiers, which make their hardware implementation difficult. This paper proposes the use of harmonic phase distribution pattern of the ECG data for MI identification. The morphological and temporal changes of the ECG waveform caused by the presence of MI are reflected in the phase distribution pattern of the Fourier harmonics. Two discriminative features, clearly reflecting these variations, are identified for each of the three standard ECG leads (II, III, and V2). Classification of the healthy and MI data is performed using a threshold-based classification rule and logistic regression. The proposed technique has achieved an average detection accuracy of 95.6% with sensitivity and specificity of 96.5% and 92.7%, respectively, for classifying all types of MI data from the Physionet Physikalisch-Technische Bundesanstalt diagnostic ECG database. The robustness of the algorithm is confirmed with real data as well. The algorithm is also implemented and validated on a microcontroller-based Arduino board, which can serve as a prototype ECG analysis device. Apart from providing comparable performance to other reported techniques, the proposed technique provides distinct advantages in terms of computational simplicity of the features, significantly reduced feature dimension, and use of simple linear classifiers which ensure faster and easier MI identification.

Future directions in resuscitation care: Towards early detection of myocardial infarction through a novel approach of VF-waveform analysis

Future directions in resuscitation care: Towards early detection of myocardial infarction through a novel approach of VF-waveform analysis

Immunohistochemistry in the Detection of Early Myocardial Infarction: Systematic Review and Analysis of Limitations Because of Autolysis and Putrefaction.

The postmortem diagnosis of acute myocardial infarction is one of the main problems in forensic practice, especially in cases in which death occurs soon after (from minutes to a few hours) the onset of the ischemic damage. Several authors have highlighted the possibility to overcome the limits of conventional histology in this diagnosis by utilizing immunohistochemistry. In the present research, we examined over 30 scientific studies and picked out over 20 main immunohistochemical antigens analyzed with a view to enabling the rapid diagnosis of early myocardial infarction. The aim of our review was to examine and summarize all the principal markers studied to date and also to consider their limitations, including protein alteration because of cadaveric autolysis and putrefaction.

Diagnosis of Early Myocardial Infarction by Histochemical Staining of Heart on Autopsy

INTRODUCTION : The incidence of Sudden Unexpected Death is increasing globally. Cardio vascular disease is the most common cause for sudden death. Eighty percent of sudden cardiac death is due to coronary arterial disease36. In 25% of cases death occurs abruptly and unexpectedly within first hour of onset of clinical symptom. Most often, the identification of early change of Myocardial infarction becomes difficult during postmortem examination, as gross change of infarct will not be apparent for 24 to 48 hrs following myocardial ischemic damage Histochemical staining techniques using azo dyes are based on the fact that ischemic myocardial cells lose their membrane integrity and release their enzyme contents in to the blood, resulting in a marked decrease or total depletion of these enzymes in the ischemic areas of the myocardium. Enzyme depleted infarct myocardium remain unstained, which is the principle of this study. AIMS AND OBJECTIVES : 1. To diagnose early Myocardial Infarction by Histochemical staining of Myocardium using Triphenyl Tetrazolium Chloride (TTC) while performing autopsy, in the absence of appreciable macroscopic changes in the myocardial tissue. 2. To confirm those identified areas of early myocardial infarction by Histopathological Examination. 3. To determine the diagnostic validity of the Histochemical Staining (TTC) of heart in gross detection of early Myocardial Infarction. MATERIALS AND METHODS: Slices from 18 hearts of suggested or suspected sudden cardiac death were incubated in 1% Triphenyl Tetrazolium Chloride Solution for 20 min. after adjusting the pH of the solution using phosphate buffer. The heart slices were examined for unstained area. Normal myocardium was stained whereas infarct areas remain unstained. Both stained and unstained areas were subjected to Histopathological examination for early Myocardial Infarction. OBSERVATION AND RESULTS: Of 18 hearts stained with TTC solution, 11 hearts showed positive TTC result, 5 hearts showed negative result, 1 heart showed false positive result and 1 heart showed false negative result. CONCLUSION : Histochemical staining using 1% TTC solution is a reliable method in detection of early myocardial infarction. Though this method has diagnostic validity of 88.88%, it could not identify death due to arrhythmias.

Electrochemical aptasensing of human cardiac troponin I based on an array of gold nanodumbbells-Applied to early detection of myocardial infarction

Recently, convergence of nanotechnology, medicine, biology and chemistry has provided novel solutions for efficient diagnosis systems for disease markers. A detection method of troponin I (TnI), as the gold standard of acute myocardial infarction biomarker, was investigated and a novel aptasensor was presented for this biomarker. An array of gold nanodumbbells was firstly synthesized using putrescine as the shape directing agent at a surface. It was then applied as a transducer for the immobilization of a 76-mer TnI aptamer to fabricate a simple electrochemical TnI aptasensor. Using the aptasensor, TnI was detected in a linear range of 0.05–500ngmL−1 with a limit of detection of 8.0pgmL−1. The aptasensor showed a diagnostic sensitivity of 100% and a diagnostic specificity of 85% when challenged with blood serum samples of 89 individuals.

Early detection of myocardial infarction following blunt chest trauma by computed tomography: a case report

BackgroundBlunt cardiac trauma encompasses a wide range of clinical entities, including myocardial contusion, cardiac rupture, valve avulsion, pericardial injuries, arrhythmia, and even myocardial infarction. Acute myocardial infarction due to coronary artery dissection after blunt chest trauma is rare and may be life threatening. Differential diagnosis of acute myocardial infarction from cardiac contusion at this setting is not easy.Case presentationHere we demonstrated a case of blunt chest trauma, with computed tomography detected myocardium enhancement defect early at emergency department. Under the impression of acute myocardial infarction, emergent coronary angiography revealed left anterior descending artery occlusion. Revascularization was performed and coronary artery dissection was found after thrombus aspiration. Finally, the patient survived after coronary stenting.ConclusionPerfusion defects of myocardium enhancement on CT after blunt chest trauma can be very helpful to suggest myocardial infarction and facilitate the decision making of emergent procedure. This valuable sign should not be missed during the initial interpretation.

Immunohistochemical detection of early myocardial infarction: a systematic review.

The postmortem diagnosis of early myocardial infarction is a challenge for forensic pathologists because the routine histology is neither specific. Many authors have suggested the use of the immunohistochemistry to fill the gaps in the histological diagnosis of early myocardial infarction. This review aims to analyse advances of immunohistochemical detection of early cardiac damage due to ischaemia. To this purpose, we reviewed experimental studies that investigated immunohistochemical markers and their estimated timing of expression. The review was performed according to specific inclusion and exclusion criteria, and a total of 23 studies assessing the immunohistochemical markers for the diagnosis and timing of early myocardial infarction were identified. The literature review highlights that the analysed markers are complement components, others being inflammatory mediators, cardiac cell proteins, plasma proteins, stress or hypoxia-induced factors and proteins associated with heart failure. All studies demonstrate the effectiveness of the tested markers in the early detection of myocardial infarction in both animal and human samples.

Heart-type fatty acid-binding protein as a diagnostic biochemical marker for early detection of myocardial infarction

Background Heart-type fatty acid binding protein has been proposed as an early biomarker of myocardial infarction. However, the usefulness of this test is still debatable.Aims We compared H-FABP with troponin and CK-MB in the early detection of acute myocardial infarction in patients presenting with chest pain with regard to sensitivity, specificity and time of detection.Methods Blood samples for H-FABP, troponin and CK-MB were obtained from 200 patients presenting with chest pain within the first 6 hours from its onset with suspicious acute coronary syndromes. Serial measurement of troponin and CK-MB were performed. Sensitivity and specificity of the cardiac markers were calculated.Results Our study showed better sensitivity of H-FABP than CK-MB and troponin (92.65% vs 54.41% and 61.76%), respectively. It showed also a specificity of 75.00%, 87.50% and 93.75% for FABP, CK-MB and troponin, respectively.Conclusion Qualitative H-FABP test showed a higher sensitivity than CK-MB and cTnI in the early detection of myocardial infarction. However, the combination with troponin is necessary to confirm the diagnosis or exclusion of acute myocardial infarction.