Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/35829
Title: Point-of-care heart-type fatty acid binding protein versus high-sensitivity troponin T testing in emergency patients at high risk for acute coronary syndrome
Authors: Kellens, S
VERBRUGGE, Frederik 
Vanmechelen, M
GRIETEN, Lars 
VAN LIERDE, Johan 
DENS, Jo 
VROLIX, Mathias 
VANDERVOORT, Pieter 
Issue Date: 2016
Publisher: SAGE PUBLICATIONS LTD
Source: European heart journal. Acute cardiovascular care (Print), 5 (2) , p. 177 -184
Abstract: Background: High-sensitivity cardiac troponin testing is used to detect myocardial damage in patients with acute chest pain. Heart-type fatty acid binding protein (H-FABP) may be an alternative, available as point-of-care test.Methods: Patients (n=203) referred by general practitioners for suspected acute coronary syndrome or presenting with typical chest pain and one major cardiovascular risk factor at the emergency department were prospectively included in a single-centre cohort study. High-sensitivity cardiac troponin T (hs-TnT) and point-of-care H-FABP testing were concomitantly performed at admission and after 6h.Results: Maximal hs-TnT levels above the 99th percentile were observed in 152 patients (75%) with 127 (63%) fulfilling criteria for myocardial infarction. Upon admission, hs-TnT and H-FABP were associated with an area under the curve (95% CI) of 0.83 (0.77-0.89) and 0.79 (0.73-0.85), respectively, to predict myocardial infarction, which increased to 0.93 (0.90-0.97) and 0.88 (0.84-0.93), respectively, after 6h. The diagnostic accuracy for non-ST-segment elevation myocardial infarction was somewhat lower with an area under the curve (95% CI) of 0.80 (0.72-0.87), 0.90 (0.84-0.96), 0.73 (0.64-0.81) and 0.77 (0.67-0.86), respectively. When assessment was performed within 3h of chest pain onset, diagnostic accuracy of H-FABP versus hs-TnT was similar. Each standard deviation increase in admission H-FABP was associated with a 68% relative risk increase of all-cause mortality (p-value=0.027) during 666155 days of follow-up.Conclusions: Point-of-care H-FABP testing has lower diagnostic accuracy compared with hs-TnT assessment in patients with high pre-test acute coronary syndrome probability, but might be of interest when assessment is possible early after chest pain onset.
Keywords: Acute coronary syndrome;FABP3 protein;myocardial infarction;prognosis
Document URI: http://hdl.handle.net/1942/35829
ISSN: 2048-8726
e-ISSN: 2048-8734
DOI: 10.1177/2048872615570221
ISI #: 000371314300011
Rights: © The European Society of Cardiology 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav
Category: A1
Type: Journal Contribution
Validations: ecoom 2021
Appears in Collections:Research publications

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