Heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction
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Heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction. / Reiter, Miriam; Twerenbold, Raphael; Reichlin, Tobias; Mueller, Mira; Hoeller, Rebecca; Moehring, Berit; Haaf, Philip; Wildi, Karin; Merk, Salome; Bernhard, Denise; Mueller, Christa Zellweger; Freese, Michael; Freidank, Heike; Botet, Isabel Campodarve; Mueller, Christian.
in: HEART, Jahrgang 99, Nr. 10, 05.2013, S. 708-714.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction
AU - Reiter, Miriam
AU - Twerenbold, Raphael
AU - Reichlin, Tobias
AU - Mueller, Mira
AU - Hoeller, Rebecca
AU - Moehring, Berit
AU - Haaf, Philip
AU - Wildi, Karin
AU - Merk, Salome
AU - Bernhard, Denise
AU - Mueller, Christa Zellweger
AU - Freese, Michael
AU - Freidank, Heike
AU - Botet, Isabel Campodarve
AU - Mueller, Christian
PY - 2013/5
Y1 - 2013/5
N2 - Objective To investigate the diagnostic and prognostic role of heart-type fatty acid-binding protein (hFABP) compared with copeptin and in addition to highsensitivity cardiac troponin T (hs-cTnT) in patients with chest pain suspected of acute myocardial infarction (AMI). Design Diagnostic and prognostic performances of hFABP, copeptin and hs-cTnT were evaluated and compared. The final diagnosis was adjudicated by two independent cardiologists. Setting This prospective observational multicentre study took place in four primary and one secondary hospital from April 2006 to September 2009. Patients We enrolled 1247 consecutive patients with suspected AMI to the emergency department. For analysis, patients were included, if baseline levels for hs-cTnT and hFABP were available (n=1074), patients with ST-segment elevation myocardial infarction (STEMI) were excluded for the diagnostic analysis (n=43). Interventions Treatment was left to the discretion of the emergency physician. Main outcome measures AMI and mortality. Results 4% of the patients had STEMI and 16% of the patients had non-STEMI. Patients with AMI had significantly higher levels of hFABP at presentation (p<0.001). Neither the combination with hFABP nor with copeptin increased the diagnostic accuracy of hs-cTnT at admission, quantified by the area under the receiver operating characteristic curve (AUC) (p>0.05). The negative predictive value regarding 90-day, 1-year and 2-year mortality was 100% (99-100), 99% (98-100) and 98% (96-99), respectively, for hFABP levels below the median (p<0.001). The accuracy of hFABP to predict 90-day mortality was moderate (AUC 0.83; 95% CI 0.77 to 0.90). Conclusions hFABP and copeptin do not improve the diagnosis of patients with chest pain without ST-segment elevation, but may be useful for risk stratification beyond hs-TnT.
AB - Objective To investigate the diagnostic and prognostic role of heart-type fatty acid-binding protein (hFABP) compared with copeptin and in addition to highsensitivity cardiac troponin T (hs-cTnT) in patients with chest pain suspected of acute myocardial infarction (AMI). Design Diagnostic and prognostic performances of hFABP, copeptin and hs-cTnT were evaluated and compared. The final diagnosis was adjudicated by two independent cardiologists. Setting This prospective observational multicentre study took place in four primary and one secondary hospital from April 2006 to September 2009. Patients We enrolled 1247 consecutive patients with suspected AMI to the emergency department. For analysis, patients were included, if baseline levels for hs-cTnT and hFABP were available (n=1074), patients with ST-segment elevation myocardial infarction (STEMI) were excluded for the diagnostic analysis (n=43). Interventions Treatment was left to the discretion of the emergency physician. Main outcome measures AMI and mortality. Results 4% of the patients had STEMI and 16% of the patients had non-STEMI. Patients with AMI had significantly higher levels of hFABP at presentation (p<0.001). Neither the combination with hFABP nor with copeptin increased the diagnostic accuracy of hs-cTnT at admission, quantified by the area under the receiver operating characteristic curve (AUC) (p>0.05). The negative predictive value regarding 90-day, 1-year and 2-year mortality was 100% (99-100), 99% (98-100) and 98% (96-99), respectively, for hFABP levels below the median (p<0.001). The accuracy of hFABP to predict 90-day mortality was moderate (AUC 0.83; 95% CI 0.77 to 0.90). Conclusions hFABP and copeptin do not improve the diagnosis of patients with chest pain without ST-segment elevation, but may be useful for risk stratification beyond hs-TnT.
UR - http://www.scopus.com/inward/record.url?scp=84876672229&partnerID=8YFLogxK
U2 - 10.1136/heartjnl-2012-303325
DO - 10.1136/heartjnl-2012-303325
M3 - SCORING: Journal article
C2 - 23514979
AN - SCOPUS:84876672229
VL - 99
SP - 708
EP - 714
JO - HEART
JF - HEART
SN - 1355-6037
IS - 10
ER -
