Early markers of myocardial injury: cTnI is enough

We compared the early diagnostic and prognostic performance of a highly sensitive cardiac troponin I (cTnI) assay with heart-type fatty acid binding protein (H-FABP), in the early hours of acute coronary syndrome. Serum samples of 293 patients were studied using the Abbott Architect cTnI assay and t...

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Published in:Clinica chimica acta 2009-02, Vol.400 (1), p.82-85
Main Authors: Ilva, Tuomo, Lund, Juha, Porela, Pekka, Mustonen, Harri, Voipio-Pulkki, Liisa-Maria, Eriksson, Susann, Pettersson, Kim, Tanner, Pirjo, Pulkki, Kari
Format: Article
Language:English
Subjects:
Acute Coronary Syndrome - blood
Acute Coronary Syndrome - diagnosis
Aged
Biomarkers - blood
Diagnosis
Fatty Acid Binding Protein 3
Fatty Acid-Binding Proteins - blood
Female
H-FABP
Humans
Male
Multivariate Analysis
Myocardial infarction
Myocardium - metabolism
Patient Admission
Prognosis
Sensitivity and Specificity
Time Factors
Troponin
Troponin I - blood
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Summary:We compared the early diagnostic and prognostic performance of a highly sensitive cardiac troponin I (cTnI) assay with heart-type fatty acid binding protein (H-FABP), in the early hours of acute coronary syndrome. Serum samples of 293 patients were studied using the Abbott Architect cTnI assay and the H-FABP assay. Special attention was paid to the diagnostic and prognostic value of admission blood samples taken < 24 h after symptom onset. The prognostic endpoint was total mortality and reinfarction at 6 months. To detect forthcoming myocardial injury, admission samples gave receiver operating curve (ROC) areas (AUC) of 0.908 for cTnI and 0.855 for H-FABP ( p = 0.068) when the delay from symptom onset was < 6 h (60.4% of all patients). When the delay was 6–24 h, the corresponding AUC values were 0.995 for cTnI and 0.849 for H-FABP ( p = 0.002). In multivariate analysis cTnI but not H-FABP predicted adverse events in all 293 patients (RR 3.02, 95% CI 1.62–5.63) and in those with delays < 6 h (RR 2.92, 95% CI 1.47–5.81). In the era of highly sensitive cTnI assays, H-FABP appears to give no additional information even in patients who present within the first 6 h after acute MI.
ISSN:0009-8981
1873-3492
DOI:10.1016/j.cca.2008.10.005