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J Korean Soc Emerg Med > Volume 20(2); 2009 > Article
Journal of The Korean Society of Emergency Medicine 2009;20(2): 163-169.
The Diagnostic Value of h-FABP (hearttype fatty acid binding protein) in Acute Myocardial Infarction
Yeong Jun Kim, Hyun Kim, Seung Min Park, Kyung Chul Cha, Kang Hyun Lee, Sung Oh Hwang
Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea. khyun@yonsei.ac.kr
ABSTRACT
PURPOSE:
Heart-type fatty acid binding protein (h-FABP) is a low molecular weight (15 kDa) protein that is abundant in the cytosol and is in high concentration in the myocardium. H-FABP is released into plasma and urine early (within 1~2 hr) after onset of myocardial injury. This study was undertaken to assess the diagnostic value of a h-FABP kit.
METHODS:
We conducted a prospective study of 73 patients who were suspected to have acute myocardial infarction and arrived within 24 hrs after the onset of chest pain from March to August 2007. Exclusion criteria were age less than 18 years and chronic renal failure.
RESULTS:
Thirty-nine patients arrived within 4 hrs (63%) and 23 arrived from 4hrs to 24hrs (37%). Upon initial EKG, ST elevation was seen in 45 cases (72%), ST depression in 7 cases (11%), T-wave inversion in 4 (6%), and arrhythmia in 5 (8%). With respect to Killip classification, 33 cases were class I (53%), 18 cases were class II (29%), 4 cases were class III (6%), and 7 cases were class IV (11%). Diagnosis was AMI in 49 cases (79%), unstable angina in 6 cases (9%), and vasospasm in 1 case (1%). Sensitivity of FABP was 71.0% on arrival at an emergency department within 4 hrs, which is higher than the sensitivities of myoglobin (48.4%), CK-MB (48.4%), and troponin-I (38.7%).
CONCLUSION:
H-FABP is more useful than other currently available biomarkers for early detection of acute myocardial infarction patients within 4 hrs of arrival at an emergency department.
Key words: Fatty acid-binding protein, Myocardial infarction, Sensitivity
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