Heart type fatty acid binding protein for rapid diagnosis of acute coronary syndromes in the emergency department

We aimed to investigate the diagnostic accuracy of H-FABP in patients with complaint of chest pain or equivalent symptoms presenting to emergency department.Patients presenting to Emergency Department (ED) with complaint of chest pain or equivalent symptoms were included into the study. Bedside point-of-care quantitative level of H-FABP was measured besides ECG interpretation, and measurement of other classical cardiac biomarkers (total CK, CK-MB, troponin I and myoglobin) in plasma. Patients were classified according to initial ECG interpretations. The measurement of H-FABP at the third hour and serial measurements of H-FABP, total CK, CK-MB, Troponin I, myoglobin and H-FABP at the sixth hour were recorded.A total of 183 patients were included to the study. Initial H-FABP was measured in a joint group of STEMI and NSTEMI, with a sensitivity of 80.9%, specificity of 19.2%, positive predictive value of 23% and negative predictive value of 77,1%. The third-hour H-FABP was measured in the group NSTEMI, with a sensitivity of 46.7%, specificity of 80.2%, positive predictive value of 42.4% and negative predictive value of 82.6%. The sixth-hour H-FABP was measured in the group of NSTEMI, with a sensitivity of 33.3%, specificity of 73.9%, positive predictive value of 24.2% and negative predictive value of 81.5%.We conclude that H-FABP is superior to myoglobin in patients in a joint group of STEMI and NSTEMI. The third-hour NPV value of H-FABP is promising for the future although it is not yet safe to shorten the cardiac observation time in patients with chest pain