Value of heart-type fatty acid-binding protein (h-fabp), cardiac troponin and myoglobin for emergency department patients with suspected acute coronary syndrome.

Introduction Fifteen percent of patients with chest pain to emergency departments are related to Acute Coronary Syndrome (ACS).It was aimed to determine the efficiency of Heart-Ttype Fatty Acid Binding Protein (H-FABP) test which is claimed to be more sensitive than the routine tests used in the early diagnosis of ACS which is still worldwide the most common death cause. Materials and Methods Patients who had admitted to Bezm-i Alem Vaqf University Hospital Emergency Department with ischemic type chest pain and suspected to have ACS were included into the study. After reporting their anamnesis patients are taken ECG from within 10 minutes. Blood samples were obtained for measurement of H-FABP, Troponin I, myoglobin, creatinine kinase, and CK-MB. SPSS for Windows version 14 statistical package was used for recording and analyzing demographical datas and findings of patients. Results Sixty-six patients were enrolled in the study. Patients of 54.5 % had ACS. 42.4 % of the 66 patients were undergone to PTCA, 9.1 % of patients placed in the coronary intensive care unit and 3 % in other clinical services. 3 % of patients died, 42.4 % of them were discharged. In diagnosing ACS, sensitivity, specifity, positive predictive value (PPV), negative predictive value (NPV) of tests, H-FABP, troponin I, myoglobin, CK-MB, respectively; were 25 %, 97 %, 90 %, 52 % (for H-FABP); 50 %, 80 %, 75 %, 57 % (for troponin I); 30 %, 97 %, 92 %, 54 %(for myoglobin); 25 %, 97 %, 90 %, 52 % (for CK-MB). In patients with STEMI and NSTEMI sensitivity, specifity, PPV, and NPV were found as 25 %, 94 %, 80 %, and 57.2 %. Discussion In our study sensitivity, specifity, PPV, and NPV of myoglobin, CK-MB, troponin I were found to be similar to other investigations's results (respectively, of myoglobin: 39.3- 75.9 %, 25-95.8 %, 5.3-100, 51.4-100 %; of CK-MB: 39.3-70 %, 35.2-97.6 %, 7.7-100 %, 50-99 %; of troponin I: 12-64.9 %, 50-100 %, 60-100 %, 34.5-92 %). Sensitivity of H-FABP was found to be smaller than other studies' (47-94.7 %), but its specifity, PPV and NPV were found similiar (respectively; 30-100 %, 44.4- 100 %, 40-100 %). Conclusion H-FABP is not a biochemical marker to be solely used in the early diagnosis of ACS. Keywords: Acute Coronary Syndrome, H-FABP