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Heart. 2010 Dec;96(24):1957-63. doi: 10.1136/hrt.2010.208272.

Heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction: a systematic review and meta-analysis.

Author information

1
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, GA Utrecht, The Netherlands. m.h.e.bruinsslot@umcutrecht.nl

Abstract

OBJECTIVE:

To determine the accuracy of heart-type fatty acid-binding protein (H-FABP) as a new and early cardiac biomarker in the early diagnosis of acute myocardial infarction (AMI). The introduction of early and safe biomarkers could lead to (a) a large reduction in unnecessary hospital referrals of patients suspected of, but not, having AMI and (b) an earlier start of treatment in patients with AMI.

DESIGN:

Diagnostic meta-analysis.

SETTING:

Hospital and pre-hospital.

PATIENTS:

Consecutive patients suspected of having AMI.

MAIN OUTCOME MEASURES:

A summary estimate for sensitivity and specificity was calculated using the bivariate random-effects approach, and covariate analysis was used to examine sources of heterogeneity between studies.

RESULTS:

A systematic search yielded 16 studies (3709 patients, prevalence of AMI 13-74%, male gender 49-84%, median age 64-76 years). The summary estimate was 84% (95% CI 76% to 90%) for sensitivity and 84% (95% CI 76% to 89%) for specificity. Covariate analyses revealed that the use of troponin in the reference standard for AMI (as opposed to creatine kinase or creatine kinase-myocardial band) had a significant impact on sensitivity.

CONCLUSION:

H-FABP does not fulfil the requirements needed for a safe and early diagnosis of AMI when used as a stand-alone test. Sound diagnostic studies examining the additional role of H-FABP combined with clinical findings and other diagnostic tests are needed to further clarify a potential future role for this cardiac biomarker.

PMID:
21088120
DOI:
10.1136/hrt.2010.208272
[Indexed for MEDLINE]

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