Incremental value of heart-type fatty acid-binding protein in suspected acute myocardial infarction early after symptom onset
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Incremental value of heart-type fatty acid-binding protein in suspected acute myocardial infarction early after symptom onset. / Schoenenberger, Andreas W; Stallone, Fabio; Walz, Brigitte; Bergner, Michael; Twerenbold, Raphael; Reichlin, Tobias; Zogg, Bernhard; Jaeger, Cedric; Erne, Paul; Mueller, Christian.
in: EUR HEART J-ACUTE CA, Jahrgang 5, Nr. 2, 04.2016, S. 185-192.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Incremental value of heart-type fatty acid-binding protein in suspected acute myocardial infarction early after symptom onset
AU - Schoenenberger, Andreas W
AU - Stallone, Fabio
AU - Walz, Brigitte
AU - Bergner, Michael
AU - Twerenbold, Raphael
AU - Reichlin, Tobias
AU - Zogg, Bernhard
AU - Jaeger, Cedric
AU - Erne, Paul
AU - Mueller, Christian
N1 - © The European Society of Cardiology 2015.
PY - 2016/4
Y1 - 2016/4
N2 - BACKGROUND: The early diagnosis of acute myocardial infarction (AMI) very soon after symptom onset remains a major clinical challenge, even when using high-sensitivity cardiac troponin (hs-cTnT).METHODS AND RESULTS: We investigated the incremental value of heart-type fatty acid-binding protein (hFABP) in a pre-specified subgroup analysis of patients presenting with suspected AMI within 1 h of symptom onset to the emergency department (ED) in a multicentre study. HFABP was measured in a blinded fashion. Two independent cardiologists using all available clinical information, including hs-cTnT, adjudicated the final diagnosis. Overall, 1411 patients were enrolled, of whom 105 patients presented within 1 h of symptom onset. Of these, 34 patients (32.4%) had AMI. The diagnostic accuracy as quantified by the area under the receiver-operating characteristics curve (AUC) of hFABP was high (0.84 (95% CI 0.74-0.94)). However, the additional use of hFABP only marginally increased the diagnostic accuracy of hs-cTnT (AUC 0.88 (95% CI 0.81-0.94) for hs-cTnT alone to 0.90 (95% CI 0.83-0.98) for the combination; p=ns). After the exclusion of 18 AMI patients with ST-segment elevation, similar results were obtained. Among the 16 AMI patients without ST-segment elevation, six had normal hs-cTnT at presentation. Of these, hFABP was elevated in two (33.3%) patients.CONCLUSIONS: hFABP does not seem to significantly improve the early diagnostic accuracy of hs-cTnT in the important subgroup of patients with suspected AMI presenting to the ED very early after symptom onset.
AB - BACKGROUND: The early diagnosis of acute myocardial infarction (AMI) very soon after symptom onset remains a major clinical challenge, even when using high-sensitivity cardiac troponin (hs-cTnT).METHODS AND RESULTS: We investigated the incremental value of heart-type fatty acid-binding protein (hFABP) in a pre-specified subgroup analysis of patients presenting with suspected AMI within 1 h of symptom onset to the emergency department (ED) in a multicentre study. HFABP was measured in a blinded fashion. Two independent cardiologists using all available clinical information, including hs-cTnT, adjudicated the final diagnosis. Overall, 1411 patients were enrolled, of whom 105 patients presented within 1 h of symptom onset. Of these, 34 patients (32.4%) had AMI. The diagnostic accuracy as quantified by the area under the receiver-operating characteristics curve (AUC) of hFABP was high (0.84 (95% CI 0.74-0.94)). However, the additional use of hFABP only marginally increased the diagnostic accuracy of hs-cTnT (AUC 0.88 (95% CI 0.81-0.94) for hs-cTnT alone to 0.90 (95% CI 0.83-0.98) for the combination; p=ns). After the exclusion of 18 AMI patients with ST-segment elevation, similar results were obtained. Among the 16 AMI patients without ST-segment elevation, six had normal hs-cTnT at presentation. Of these, hFABP was elevated in two (33.3%) patients.CONCLUSIONS: hFABP does not seem to significantly improve the early diagnostic accuracy of hs-cTnT in the important subgroup of patients with suspected AMI presenting to the ED very early after symptom onset.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Early Diagnosis
KW - Emergency Service, Hospital
KW - Fatty Acid Binding Protein 3
KW - Fatty Acid-Binding Proteins/metabolism
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Myocardial Infarction/diagnosis
KW - Prospective Studies
KW - ROC Curve
KW - Troponin T/metabolism
KW - Young Adult
U2 - 10.1177/2048872615571256
DO - 10.1177/2048872615571256
M3 - SCORING: Journal article
C2 - 25681485
VL - 5
SP - 185
EP - 192
JO - EUR HEART J-ACUTE CA
JF - EUR HEART J-ACUTE CA
SN - 2048-8726
IS - 2
ER -
