The role of heart-type fatty acid-binding protein in the diagnosis of acute coronary syndrome

BACKGROUND:

Heart-type fatty acid-binding protein (H-FABP) is a membrane-bound protein that facilitates transport of fatty acids from the blood into the heart. It is currently being used outside the United States for the early diagnosis of myocardial infarction (MI). However, previous studies have shown inconsistent correlation of H-FABP with standard cardiac biomarkers.

METHODS:

Fifty patients admitted with ST segment elevation MI (n=25), non-ST segment elevation MI (n=15) or unstable angina (n=10) were evaluated. The CardioDetect med cardiac infarction test (rennesens GmbH, Germany) was used to measure both qualitative and quantitative H-FABP.

RESULTS:

Of the 40 patients with acute MI, the initial troponin assay was positive in 35 patients (88%), the qualitative H-FABP assay was positive in 23 patients (58%) and the quantitative H-FABP assay was positive in 15 patients (38%) (P=0.001). No patient with MI had a positive H-FABP assay with a negative initial troponin assay.

CONCLUSION:

In the present study, the results of both the qualitative and quantitative H-FABP assays neither appeared earlier nor provided increased sensitivity compared with troponin in diagnosing acute MI. Accordingly, the use of H-FABP as a diagnostic tool for MI is limited.