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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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