Comparison of Heart-type Fatty Acid Binding Protein (H-FABP), cTnI and CK-MB in Diagnosis of Early AMI

Objective To compare the diagnostic efficacy of a newly developed whole blood rapid panel test for heart-type fatty acid binding protein (H-FABP) with that of cardiac troponin I (cTnI) and creatine kinase isoenzyme MB (CK-MB). Methods Eighty-two patients with suspected acute myocardial infarction (AMI) according to certain time frames from onset to presentation. The rapid panel test method was applied to detect the H-FABP and cTnI. The serum CK-MB activity was determined with an immuno-inhibition assay kit. The sensitivity and specificity in diagnosis of early AMI were analyzed between H-FABP and cTnI and CK-MB. Results Final diagnosis was confirmed within 42 patients who were suspected AMI. The overall sensitivities of H-FABP, cTnI and CK-MB were 85.7%, 76.2% and 31.7%, respectively. The relative sensitivities of these 3 markers were 66.7%, 100% and 0% for AMI patients presented within 3h of onset of symptom; 100%, 67% and 67% for those between 3 and 6h. While the relative specificities of these 3 markers were 100%, 50% and 100% within 3h of onset, and 94%, 75% and 100% for those between 3h and 6h. Negative predictive values were 100%, 67% and 84% for patients within 6h of onset. Conclusions H-FABP is more sensitive and specific in diagnosis of early AMI, which may has great potential as an excellent biochemical cardiac marker for diagnosis of AMI in the early phase.