Importance of H-FABP in Early Diagnosis of Acute Myocardial Infarction.

Abstract

Background: Over the years, troponins have aced the para-clinical tests for confirming the diagnosis of acute myocardial infarction. However, the rise in their levels is entirely time-dependent, which can cause a delay in the initiation of treatment protocols. Heart fatty acid binding protein (H-FABP) can serve comparatively as a better biological marker for overcoming this flaw of troponins, as it is quickly released into the bloodstream once the myocardial injury occurs due to decreased blood supply. This study aimed to evaluate the usefulness of this marker as well as establish the specificity and sensitivity of testing the H-FABP, if it adds to early diagnosis and can be relied upon in the future.

Material and methods: We evaluated 83 patients and their H-FABP levels, along with the standard cardiac markers like hsTni and CK-MB, in patients presenting with symptoms indicating an ongoing coronary event, who had presented to our hospital between August 2020 and June 2021. The patients were divided into two groups: group 1 comprised patients who had first medical contact within 4 hours of the onset of chest pain, and group 2 patients who had first medical contact after 4 hours of the appearance of symptoms. Statistical analysis was performed using MedCalc v20.023, considering statistical significance values of p <0.05. Results for targeted variables are presented using descriptive statistics (mean, standard deviation, range, median, and associated interquartile range) for continuous data, and counts with associated percentages for categorical data.

Results: H-FABP was found to have better sensitivity and specificity of 89.67 and 95.65 in group 1 patients and 86.73 and 49.84, respectively, in group 2 patients. The other two cardiac biomarkers evaluated had lower values in response to H-FABP in the first 4 hours of presentation. Results for group 2 showed that specificitivity for hsTni is higher than that of H-FABP, that is, 69.98.

Conclusion: Heart fatty acid binding protein (H-FABP) should be included in the protocol for biochemical evaluation of all patients presenting to the emergency services with a suspicion of possible myocardial infarction. Early detection of this protein can help in effective and timely management of myocardial infarction, thus further decreasing mortality rates and the financial burden on healthcare systems worldwide.