DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20211430

Quantitative analysis of heart type fatty acid binding protein in early detection of acute coronary syndrome

Kushal Tarapur, Adarsha Gopadi Krishna Bhat, Nithin Bhat, Manjunatha Handattu Hande

Abstract


Background: Coronary heart disease is a major cause of mortality, morbidity and disability in developed countries. Even though coronary heart disease mortality rates worldwide have reduced over the past five decades, coronary heart disease is the major cause of death in one-third of people more than 35 years of age.Many risk factors and biomarkers have been studied in the past and research is on in detecting the acute coronary syndrome at the earliest so that reperfusion therapy can be undertaken as early as possible to save the life of patients. Heart-type fatty acid binding protein is a newer modality of investigation developed for the above purpose.

Methods: Single centre cross-sectional observational study was conducted from 1 September 2017 to May 2019 with an aim to study novel cardiac biomarker h-FABP in patients with acute coronary syndrome and compare sensitivity and specificity of the same with that of troponin -T in the early detection of acute coronary events after fulfilling inclusion and exclusion criteria .The data of 80 patients were collected after getting informed consent. The clinical, demographic and investigations were performed as per the hospital protocol and such patients were recorded in the proforma. The additional test heart-type fatty acid binding protein is performed in the triage by collecting patient’s serum and by using point of care analysis machine. Statistical analysis was performed using SPSS version 20.0 and results were obtained

Results: Out of 80 patients selected males were 35 and female are 45. Chest pain was present in 58 people, dyspnoea was in 28, sweating in 40 people, 35 had anterior wall MI, 30 had Inferior wall MI and 15 had global hypokinesia. Median values of h-FABP values were 82 ng/dl, 53.2 ng/dl, 35.3 ng/dl at 0-6 hours, 6-12 hours, and 12-24 hours respectively after the onset of symptoms with a significant p< 0.001. There were major differences between median values between different time groups of symptoms onset. Median troponin T values were 0.061 ng/ml, 0.350 ng/ml, 1.56 ng/ml after 0-6 hours, 6-12 hours and 12-24 hours of onset of symptoms respectively. There was no correlation between h-FABP and troponin-T values.

Conclusions: h-FABP rises early in coronary events in first 6 hrs of onset of symptoms of ACS serum levels of h-FABP decreases as time progresses in 24 hours. In comparison troponin-t levels continue to rise as time progresses. h-FABP serum levels can be used as novel marker for early detection of ACS.


Keywords


h-FABP, MI, Acute coronary syndrome, NSTEMI

Full Text:

PDF

References


Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, et al. Heart disease and stroke statistics-2018 update: a report from the American heart association. Circulation. 2018;137 (12):e67-492.

Gordon T, Kannel WB, Hjortland MC, McNamara PM. Menopause and coronary heart disease. Ann Intern Med. 1978;89(2):157-61.

The joint European society of cardiology/American college of cardiology committee. Myocardial infarction redefined. Eur Heart J. 2000;21:1502-13.

Viswanathan K, Kilcullen N, Morrell C, Thistlethwaite SJ, Sivananthan MU, Hassan TB, et al. Heart-type fatty acid-binding protein predicts long-term mortality and re-infarction in consecutive patients with suspected acute coronary syndrome who are troponin-negative. J Am Coll Cardiol. 2010; 55(23):2590-8.

Viswanathan K, Hall AS, Barth JH. An evidence-based approach to the assessment of heart-type fatty acid binding protein in acute coronary syndrome. Clin Biochem Rev. 2012;33(1):3.

Okamoto F, Sohmiya K, Ohkaru Y, Kawamura K, Asayama K, Kimura H, et al. Human heart-type cytoplasmic fatty acid-binding protein (H-FABP) for the diagnosis of acute myocardial infarction. Clin Chem Lab Med. 2000;38(3):231-8.

Reddy LL, Shah SA, Dherai AJ, Ponde CK, Ashavaid TF. Troponin T and heart type fatty acid binding protein (h-FABP) as biomarkers in patients presenting with chest pain. Indian J Clin Biochem. 2016;31(1):87-92.

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(1-2):26-30.

Goel H, Melot J, Krinock MD, Kumar A, Nadar SK, Lip GYH. Heart-type fatty acid-binding protein: an overlooked cardiac biomarker. Ann Med. 2020;52 (8):444-61.

Chan D, Ng LL. Biomarkers in acute myocardial infarction. BMC Med. 2010;34(8):52-9.

Mannu GS. The non-cardiac use and significance of cardiac troponins. Scott Med J. 2014;59(3):172-8.

Gururajan P, Gurumurthy P, Nayar P, Srinivasa NRG, Babu S, Cherian KM. Heart fatty acid binding protein (h-FABP) as a diagnostic biomarker in patients with acute coronary syndrome. Heart Lung Circ. 2010;19(11):660-4.