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Complementary Diagnostic Value of Heart Type Fatty Acid-binding Protein in Early Detection of Acute Myocardial Infarction. Crit Pathw Cardiol 2019; 17:43-46. [PMID: 29432376 DOI: 10.1097/hpc.0000000000000107] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Heart-type fatty acid-binding protein (H-FABP) is a novel biomarker for myocardial injury. We compared the use of H-FABP with serum levels of cardiac troponin-T (cTnT) and creatine kinase-MB (CK-MB) in the diagnosis of patients suspicious to acute myocardial infarction (AMI). METHODS From October 2013 to December 2014, 182 consecutive patients suspicious to acute coronary syndrome were enrolled in this study, who presented within the past 6 hours from the onset of symptoms. Venous blood samples were drawn at baseline to measure serum biochemistry, high-sensitive cardiac troponin T (hs-cTNT), creatine kinase-MB, and H-FABP, and the measurements were repeated after 8 hours. The patients were categorized into 3 groups based on the baseline and second measurements of cTnT and general characteristics, and changes of H-FABP levels were then compared between the groups. Sensitivity and specificity of H-FABP in predicting the presence of AMI was calculated. RESULTS A total of 91 patients had AMI. Changes of H-FABP through time were also significantly different between the AMI and non-AMI patients (P < 0.001). A cutoff point of 7.15 for H-FABP could predict AMI with a sensitivity of 51.5%, specificity of 96.3%, and diagnostic accuracy of 68.3%. The area under the receiver operating characteristic curve for H-FABP at 8 hours was 79.4% (95% confidence interval: 73.0-85.9; P < 0.001). Positive predictive value and negative predictive value for H-FABP were 85% and 60%, respectively. CONCLUSIONS H-FABP can be used as an additional cardiac biomarker in the diagnosis of AMI.
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Deng F, Zhao Q, Deng Y, Wu Y, Zhou D, Liu W, Yuan Z, Zhou J. Prognostic significance and dynamic change of plasma macrophage migration inhibitory factor in patients with acute ST-elevation myocardial infarction. Medicine (Baltimore) 2018; 97:e12991. [PMID: 30412132 PMCID: PMC6221611 DOI: 10.1097/md.0000000000012991] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Macrophage migration inhibitory factor (MIF) has been reported as an inflammatory cytokine in many inflammatory diseases, including rheumatoid arthritis and ischemic diseases. However, dynamic changes of MIF within the first 24 hours on admission and potential prognostic significance following ST-elevation myocardial infarction (STEMI) have been little known. In this study, we examined the dynamic change of MIF level and its potential diagnostic and prognostic value after the onset of STEMI. Plasma MIF levels were evaluated in symptomatic subjects who received coronary angiogram with a median 27 months follow-up for the development of major adverse cardiovascular events (MACEs).Of all 993 subjects, patients with STEMI showed a significantly higher MIF levels than in patients with non-ST elevation acute coronary syndrome, stable angina, and normal coronary artery, respectively (P < .01). Plasma MIF levels elevated as early as 12 hours post-onset of STEMI and peaked rapidly within 24 hours, and remained elevated from about day 5 till day 9 during hospitalization. In multivariate analysis, MIF was associated with a decreased risk of MACEs occurrence in STEMI patients after adjustment for traditional cardiovascular risk factors [hazard ratio 0.81, (0.72-0.90), P < .001]. The ROC curve for MACEs was 0.72 (95% CI 0.62-0.80, P < .001) and 0.85 (95% CI 0.80-0.90, P < .001) using Framingham risk factors only and combined with MIF, individually.Measurement of MIF adds potential information for the early diagnosis of acute STEMI and significantly improves risk prediction of MACEs when added to a prognostic model with traditional Framingham risk factors.
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Affiliation(s)
- Fuxue Deng
- Department of Cardiovascular Medicine, the First Affiliated Hospital of Xi’an Jiaotong University College of Medicine
| | - Qiang Zhao
- Department of Cardiovascular Medicine, the First Affiliated Hospital of Xi’an Jiaotong University College of Medicine
| | - Yangyang Deng
- Department of Cardiovascular Medicine, the First Affiliated Hospital of Xi’an Jiaotong University College of Medicine
| | - Yue Wu
- Department of Cardiovascular Medicine, the First Affiliated Hospital of Xi’an Jiaotong University College of Medicine
| | - Dong Zhou
- Department of Cardiovascular Medicine, the First Affiliated Hospital of Xi’an Jiaotong University College of Medicine
| | - Weimin Liu
- Department of Cardiovascular Medicine, the First Affiliated Hospital of Xi’an Jiaotong University College of Medicine
| | - Zuyi Yuan
- Department of Cardiovascular Medicine, the First Affiliated Hospital of Xi’an Jiaotong University College of Medicine
- Key Laboratory of Environment and Genes Related to Diseases (Xi’an Jiaotong University), Ministry of Education, Xi’an, Shaanxi, P.R. China
| | - Juan Zhou
- Department of Cardiovascular Medicine, the First Affiliated Hospital of Xi’an Jiaotong University College of Medicine
- Key Laboratory of Molecular Cardiology
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Diagnostic and prognostic value of H-FABP in acute coronary syndrome: Still evidence to bring. Clin Biochem 2018; 58:1-4. [DOI: 10.1016/j.clinbiochem.2018.04.021] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 04/20/2018] [Accepted: 04/23/2018] [Indexed: 11/19/2022]
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Spencer TR, Sidhu MS, Bisaillon J, Christopher King C. Novel Cardiac Biomarkers for Emergency Department Evaluation of Acute Coronary Syndrome: The Recent Evidence on Non-troponin Biomarkers and Their Limitations. CURRENT EMERGENCY AND HOSPITAL MEDICINE REPORTS 2016. [DOI: 10.1007/s40138-016-0104-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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5
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Fan F, Fang L, Moore XL, Xie X, Du XJ, White DA, O'Brien J, Thomson H, Wang J, Schneider HG, Ellims A, Barber TW, Dart AM. Plasma Macrophage Migration Inhibitor Factor Is Elevated in Response to Myocardial Ischemia. J Am Heart Assoc 2016; 5:JAHA.115.003128. [PMID: 27364992 PMCID: PMC5015363 DOI: 10.1161/jaha.115.003128] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Macrophage migration inhibitory factor (MIF) is a key regulator of inflammatory responses, including in the heart. Plasma MIF is elevated early in the course of acute myocardial infarction. In this study, we hypothesized that plasma MIF may also be increased in acute myocardial ischemia. METHODS AND RESULTS Patients undergoing cardiac stress test (stress nuclear myocardial perfusion scan or stress echocardiography) were recruited. Twenty-two patients had a stress test indicative of myocardial ischemia and were compared with 62 patients who had a negative stress test. Plasma MIF was measured by ELISA before and after the stress test. MIF was also measured in patients with peripheral arterial occlusive disease before and after exercise causing claudication. Gene and protein expression of MIF was measured in mouse cardiac and skeletal muscle tissue by real-time polymerase chain reaction and western blot, respectively. Plasma MIF was elevated at 5 and 15 minutes after stress (relative to before stress) in patients with a positive test, compared with those with a negative test. In contrast, high-sensitivity troponin T and C-reactive protein were not altered after stress in either group. MIF was not altered after exercise in PAOD patients, despite the occurrence of claudication, suggesting that plasma MIF is not a marker for skeletal muscle ischemia. This may be explained by a lower gene and protein expression of MIF in skeletal muscle than the heart. CONCLUSIONS Our results suggest that plasma MIF is an early marker for acute myocardial ischemia.
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Affiliation(s)
- Fenling Fan
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia Department of Cardiovascular Medicine, The 1st Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, China
| | - Lu Fang
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Xiao-Lei Moore
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Xuegang Xie
- Department of Cardiovascular Medicine, The 1st Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, China
| | - Xiao-Jun Du
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - David A White
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Jessica O'Brien
- Department of Cardiovascular Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Helen Thomson
- Department of Cardiovascular Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Jun Wang
- Department of Cardiovascular Medicine, The 1st Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, China
| | - Hans G Schneider
- Department of Chemical Pathology, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Andris Ellims
- Department of Cardiovascular Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Thomas W Barber
- Department of Nuclear Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Anthony M Dart
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia Department of Cardiovascular Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
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Pyati AK, Devaranavadagi BB, Sajjannar SL, Nikam SV, Shannawaz M, Patil S. Heart-Type Fatty Acid-Binding Protein, in Early Detection of Acute Myocardial Infarction: Comparison with CK-MB, Troponin I and Myoglobin. Indian J Clin Biochem 2016; 31:439-45. [PMID: 27605741 DOI: 10.1007/s12291-015-0544-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Accepted: 12/18/2015] [Indexed: 11/25/2022]
Abstract
The study aimed to investigate whether heart-type fatty acid binding protein (H-FABP) measurement provides additional diagnostic value to that of conventional cardiac markers in acute myocardial infarction (AMI) within first 6 h after the onset of symptoms. The study included 120 subjects: 60 AMI cases and 60 age and sex matched controls. The cases and controls were further divided into 2 subgroups depending on the time since onset of chest pain as (1) subjects within 3 h and (2) between 3 and 6 h of onset of chest pain. In all the cases and controls, serum H-FABP concentration was measured by Immunoturbidimetric method, serum Troponin I and myoglobin concentrations by Chemiluminescence immunoassay and serum CK-MB concentration by Immuno-inhibition method. The sensitivity, specificity, positive and negative predictive values of H-FABP were significantly greater than CK-MB and myoglobin but were lesser than Troponin I in patients with suspected AMI in both within 3 h and 3-6 h groups. Receiver operating characteristic curves demonstrated greatest diagnostic ability for Troponin I (AUC = 0.99, p < 0.001) followed by H-FABP (AUC = 0.906, p < 0.001) within 3 h and 3-6 h after the onset of chest pain. In conclusion, the diagnostic value of H-FABP is greater than CK-MB and myoglobin but slightly lesser than troponin I for the early diagnosis of AMI within first 6 h of chest pain. H-FABP can be used as an additional diagnostic tool for the early diagnosis of AMI along with troponin I.
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Affiliation(s)
- Anand K Pyati
- Department of Biochemistry, BLDE University's Shri B M Patil Medical College, Hospital and Research Centre, Vijayapur, Karnataka India ; Department of Biochemistry, Belagavi Institute of Medical Sciences (BIMS), Dr B R Ambedkar Road, Belagavi, Karnataka 590001 India
| | - Basavaraj B Devaranavadagi
- Department of Biochemistry, BLDE University's Shri B M Patil Medical College, Hospital and Research Centre, Vijayapur, Karnataka India
| | - Sanjeev L Sajjannar
- Department of Cardiology, BLDE University's Shri B M Patil Medical College, Hospital and Research Centre, Vijayapur, Karnataka India
| | - Shashikant V Nikam
- Department of Biochemistry, Belagavi Institute of Medical Sciences (BIMS), Dr B R Ambedkar Road, Belagavi, Karnataka 590001 India
| | - Mohd Shannawaz
- Department of Community Medicine, BLDE University's Shri B M Patil Medical College, Hospital and Research Centre, Vijayapur, Karnataka India
| | - Satish Patil
- Department of Physiology, BLDE University's Shri B M Patil Medical College, Hospital and Research Centre, Vijayapur, Karnataka India
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Gerede DM, Güleç S, Kılıçkap M, Kaya CT, Vurgun VK, Özcan ÖU, Göksülük H, Erol Ç. Comparison of a qualitative measurement of heart-type fatty acid-binding protein with other cardiac markers as an early diagnostic marker in the diagnosis of non-ST-segment elevation myocardial infarction. Cardiovasc J Afr 2015; 26:204-9. [PMID: 26212703 PMCID: PMC4780021 DOI: 10.5830/cvja-2015-028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 03/16/2015] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE Heart-type fatty acid-binding protein (H-FABP) is a novel cardiac marker used in the early diagnosis of acute myocardial infarction (AMI), which shows myocyte injury. Our study aimed to compare bedside H-FABP measurements with routine creatine kinase-MB (CK-MB) and troponin I (TnI) tests for the early diagnosis of non-ST-elevation MI (NSTEMI), as well as for determining its exclusion capacity. METHODS A total of 48 patients admitted to the emergency room within the first 12 hours of onset of ischaemic-type chest pain lasting more than 30 minutes and who did not have ST-segment elevation on electrocardiography (ECG) were included in the study. Definite diagnoses of NSTEMI were made in 24 patients as a result of 24-hour follow up, and the remaining 24 patients did not develop MI. RESULTS When various subgroups were analysed according to admission times, H-FABP was found to be a better diagnostic marker compared to CK-MB and TnI (accuracy index 85%), with a high sensitivity (79%) and specificity (93%) for early diagnosis ( ≤ six hours). The respective sensitivities of bedside H-FABP and TnI tests were 89 vs 33% (p < 0.05) for patients presenting within three hours of onset of symptoms. CONCLUSION Bedside H-FABP measurements may contribute to correct early diagnoses, as its levels are elevated soon following MI, and measurement is easy, with a rapid result.
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Affiliation(s)
| | - Sadi Güleç
- Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey
| | - Mustafa Kılıçkap
- Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey
| | - Cansın Tulunay Kaya
- Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey
| | - Veysel Kutay Vurgun
- Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey
| | - Özgür Ulaş Özcan
- Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey
| | - Hüseyin Göksülük
- Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey
| | - Çetin Erol
- Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey
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Reichlin T, Cullen L, Parsonage WA, Greenslade J, Twerenbold R, Moehring B, Wildi K, Mueller S, Zellweger C, Mosimann T, Rubini Gimenez M, Rentsch K, Osswald S, Müller C. Two-hour algorithm for triage toward rule-out and rule-in of acute myocardial infarction using high-sensitivity cardiac troponin T. Am J Med 2015; 128:369-79.e4. [PMID: 25446294 DOI: 10.1016/j.amjmed.2014.10.032] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 10/15/2014] [Accepted: 10/20/2014] [Indexed: 01/06/2023]
Abstract
BACKGROUND High-sensitivity cardiac troponin (hs-cTn) may allow an earlier diagnosis of acute myocardial infarction (AMI). METHODS We prospectively enrolled 1148 (derivation cohort) and 517 (external validation cohort) unselected patients presenting with suspected AMI to the emergency department. Final diagnosis was adjudicated by 2 independent cardiologists. Hs-cTnT was measured at presentation and after 2 hours. A diagnostic algorithm incorporating hs-cTnT values at presentation and absolute changes within the first 2 hours was derived. RESULTS AMI was the final diagnosis in 16% of patients in the derivation and 9.1% in the validation cohort. The 2-hour algorithm developed in the derivation cohort classified 60% of patients as "rule-out," 16% as "rule-in," and 24% in the "observational-zone." Resulting sensitivity and negative predictive value (NPV) were 99.5% and 99.9%, respectively, for rule-out, and specificity and positive predictive value (PPV) were 96% and 78%, respectively, for rule-in. Applying the 2-hour triage algorithm in the external validation cohort, 78% of patients could be classified as "rule-out," 8% as "rule-in," and 14% in the "observational-zone." Resulting sensitivity and NPV were 96% and 99.5%, respectively, for rule-out, and specificity and PPV were 99% and 85%, respectively, for rule-in. Cumulative 30-day survival rates were 100%, 98.9%, and 95.2% (P < .001), and 100%, 100%, and 95% (P < .001) in patients classified as "rule-out," "observational-zone," and "rule-in" in the 2 cohorts, respectively. CONCLUSIONS A simple algorithm incorporating hs-cTnT baseline values and absolute changes over 2 hours allowed a triage toward safe rule-out, or accurate rule-in, of AMI in the vast majority of patients, with only 20% requiring more prolonged monitoring and serial blood sampling.
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Affiliation(s)
- Tobias Reichlin
- Department of Cardiology, University Hospital Basel, Switzerland; Department of Internal Medicine, University Hospital Basel, Switzerland
| | - Louise Cullen
- Royal Brisbane and Women's Hospital, Australia; Queensland University of Technology, Brisbane, Australia; University of Queensland, Brisbane, Australia
| | - William A Parsonage
- Royal Brisbane and Women's Hospital, Australia; University of Queensland, Brisbane, Australia
| | - Jaimi Greenslade
- Royal Brisbane and Women's Hospital, Australia; Queensland University of Technology, Brisbane, Australia; University of Queensland, Brisbane, Australia
| | - Raphael Twerenbold
- Department of Cardiology, University Hospital Basel, Switzerland; Department of Internal Medicine, University Hospital Basel, Switzerland
| | - Berit Moehring
- Department of Cardiology, University Hospital Basel, Switzerland
| | - Karin Wildi
- Department of Cardiology, University Hospital Basel, Switzerland
| | - Sandra Mueller
- Department of Cardiology, University Hospital Basel, Switzerland
| | | | - Tamina Mosimann
- Department of Cardiology, University Hospital Basel, Switzerland
| | | | | | - Stefan Osswald
- Department of Cardiology, University Hospital Basel, Switzerland
| | - Christian Müller
- Department of Cardiology, University Hospital Basel, Switzerland; Department of Internal Medicine, University Hospital Basel, Switzerland.
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Lauque D, Maupas-Schwalm F, Bounes V, Juchet H, Bongard V, Roshdy A, Botella JM, Charpentier S. Predictive value of the heart-type fatty acid-binding protein and the Pulmonary Embolism Severity Index in patients with acute pulmonary embolism in the emergency department. Acad Emerg Med 2014; 21:1143-50. [PMID: 25308138 DOI: 10.1111/acem.12484] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 06/07/2014] [Accepted: 06/08/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Heart-type fatty acid-binding protein (h-FABP), sensitive troponins, natriuretic peptides, and clinical scores such as the Pulmonary Embolism Severity Index (PESI) are candidates for risk stratification of patients with acute pulmonary embolism (PE). The aim was to compare their respective prognostic values to predict an adverse outcome at 1 month. METHODS The authors prospectively included 132 consecutive patients with confirmed acute PE. On admission to the emergency department (ED), plasma concentrations of h-FABP, sensitive cardiac troponin I-Ultra (cTnI-Ultra), and brain natriuretic peptide (BNP) were measured and the PESI calculated in all patients. The combined 30-day outcomes of interest were death, cardiac arrest, mechanical ventilation, use of catecholamines, and recurrence of acute PE. RESULTS During the first 30 days, 14 (10.6%) patients suffered complications. Among the biomarkers, h-FABP above 6 μg/L was a stronger predictor of an unfavorable outcome (odds ratio [OR] = 17.5, 95% confidence interval [CI] = 4.2 to 73.3) than BNP > 100 pg/mL (OR = 5.7, 95% CI = 1.6 to 20.4) or cTnI-Ultra > 0.05 μg/L (OR = 3.4, 95% CI = 1.1 to 10.9). The PESI classified 83 of 118 patients (70.3%) with favorable outcomes and only one of 14 (7%) with adverse outcomes in low class I or II (OR = 30.8, 95% CI = 3.2 to 299.7). The areas under the receiver operating characteristic (ROC) curves (AUCs) were 0.90 (95% CI = 0.81 to 0.98) for h-FABP, 0.89 (95% CI = 0.82 to 0.96) for PESI, 0.79 (95% CI = 0.67 to 0.90) for BNP, and 0.76 (95% CI = 0.64 to 0.87) for cTnI-Ultra. The combination of h-FABP with PESI was a particularly useful prognostic indicator because none of the 79 patients (59.8%) with h-FABP < 6 ng/mL and PESI class < III had an adverse outcome. CONCLUSIONS h-FABP and the PESI are superior to BNP and cTnI-Ultra as markers for risk stratification of patients with acute PE. The high sensitivity of their combination identified a large number of low-risk patients in the ED.
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Affiliation(s)
- Dominique Lauque
- The Emergency Department; Rangueil University Hospital; Toulouse France
- University Toulouse 3; Toulouse France
| | - Françoise Maupas-Schwalm
- The Department of Biochemistry; Rangueil University Hospital; Toulouse France
- University Toulouse 3; Toulouse France
| | - Vincent Bounes
- The Emergency Department; Rangueil University Hospital; Toulouse France
| | - Henry Juchet
- The Emergency Department; Rangueil University Hospital; Toulouse France
| | - Vanina Bongard
- The Department of Epidemiology; Health Economics and Public Health University; Toulouse France
- INSERM UMR1027; Toulouse France
| | - Ashraf Roshdy
- The Cardiothoracic Intensive Therapy Unit; St. George's Hospital; London UK
| | - Jean Marie Botella
- The Department of Biochemistry; Rangueil University Hospital; Toulouse France
| | - Sandrine Charpentier
- The Emergency Department; Rangueil University Hospital; Toulouse France
- University Toulouse 3; Toulouse France
- INSERM UMR1027; Toulouse France
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10
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Banu KY, Niyazi OD, Erdem C, Dpekçi Afşin DH, Ozlem U, Yasemin C, Afsin I. Value of heart-type fatty acid-binding protein (H-FABP) for emergency department patients with suspected acute coronary syndrome. Afr Health Sci 2014; 14:757-62. [PMID: 25352899 DOI: 10.4314/ahs.v14i3.36] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE The aim of this study is testing the value of H-FABP in the early diagnosis of ACS alone or with routinely used biomarkers such as myoglobin, CK-MB, and cTn I in patients who admitted to emergency department (ED) with complaint of chest pain and suspected acute coronary syndrome. MATERIAL AND METHODS This prospective and cross-sectional study was performed at the Emergency Department of University hospital between June 2009 and September 2010. Patients who were admitted with chest pain within first 48 hours and suspected ACS were enrolled to the study. Blood samples were taken for CK-MB, myoglobin, cTnI and H-FABP The patients were divided into two groups (ACS and non ACS). Statistical analyse were used for relation of biomarkers with diagnosis of ACS. RESULTS A 66 patients were included to the study. H-FAPB values were positive in 15.2% patients. When H-FABP was added to routinely used biomarkers in the diagnosis of ACS, increasing was observed in all sensitivity, specificity, PPV and NPV values. However, this increase was not statistically significant. CONCLUSION H-FABP did not provide any significant change in early diagnosis and exclusion of ACS diagnosis when used either alone or combination with routinely used biomarkers.
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Affiliation(s)
| | | | | | | | - Uzun Ozlem
- Bağcılar Research and Training Hospital, Emergency Department
| | - Celik Yasemin
- Bağcılar Research and Training Hospital, Emergency Department
| | - Ipekci Afsin
- Faculty of Cerrahpaşa Medicine, Đstanbul University, Emergency department
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11
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Millard RW, Tranter M. Complementary, alternative, and putative nontroponin biomarkers of acute coronary syndrome: new resources for future risk assessment calculators. ACTA ACUST UNITED AC 2014; 67:312-20. [PMID: 24774594 DOI: 10.1016/j.rec.2013.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 12/23/2013] [Indexed: 11/16/2022]
Abstract
Biomarkers, other than cardiac troponin, with potential sensitivity and selectivity that provide diagnostic and prognostic insights into the tissue-specific injury processes underlying acute coronary syndrome and their possible use in risk stratification algorithms are discussed. Such biomarkers may be useful as complementary or alternative to cardiac troponin (I or T) assays in early diagnosis of acute coronary syndrome, as well as for monitoring acute coronary syndrome progression and prognosis assessment. The information included in this article is based on a critical analysis of selected published biomedical literature accessible through the United States National Library of Medicine's MEDLINE-PubMed and Scopus search engines. The majority of articles cited in this review and perspective, except for a few historical publications as background, were published between January 2000 and December 2013.
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Affiliation(s)
- Ronald W Millard
- Department of Pharmacology & Cell Biophysics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States.
| | - Michael Tranter
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
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12
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Millard RW, Tranter M. Biomarcadores no troponínicos, complementarios, alternativos y presuntos, para el síndrome coronario agudo: nuevos recursos para los futuros instrumentos de cálculo del riesgo. Rev Esp Cardiol 2014. [DOI: 10.1016/j.recesp.2013.12.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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13
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Glatz JFC, Renneberg R. Added value of H-FABP as plasma biomarker for the early evaluation of suspected acute coronary syndrome. ACTA ACUST UNITED AC 2014. [DOI: 10.2217/clp.13.87] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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14
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Deddens JC, Colijn JM, Oerlemans MIFJ, Pasterkamp G, Chamuleau SA, Doevendans PA, Sluijter JPG. Circulating microRNAs as novel biomarkers for the early diagnosis of acute coronary syndrome. J Cardiovasc Transl Res 2013; 6:884-98. [PMID: 23897095 DOI: 10.1007/s12265-013-9493-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 06/18/2013] [Indexed: 12/18/2022]
Abstract
Small non-coding microRNAs (miRNAs) are important physiological regulators of post-transcriptional gene expression. miRNAs not only reside in the cytoplasm but are also stably present in several extracellular compartments, including the circulation. For that reason, miRNAs are proposed as diagnostic biomarkers for various diseases. Early diagnosis of acute coronary syndrome (ACS), especially non-ST elevated myocardial infarction and unstable angina pectoris, is essential for optimal treatment outcome, and due to the ongoing need for additional identifiers, miRNAs are of special interest as biomarkers for ACS. This review highlights the nature and cellular release mechanisms of circulating miRNAs and therefore their potential role in the diagnosis of myocardial infarction. We will give an update of clinical studies addressing the role of circulating miRNA expression after myocardial infarction and explore the diagnostic value of this potential biomarker.
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Affiliation(s)
- J C Deddens
- Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Heidelberglaan 100, room G02.523, 3584, CX, Utrecht, The Netherlands
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Lippi G, Mattiuzzi C, Cervellin G. Critical review and meta-analysis on the combination of heart-type fatty acid binding protein (H-FABP) and troponin for early diagnosis of acute myocardial infarction. Clin Biochem 2013; 46:26-30. [DOI: 10.1016/j.clinbiochem.2012.10.016] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 10/13/2012] [Accepted: 10/15/2012] [Indexed: 12/24/2022]
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