Schoenenberger, Andreas; Stallone, Fabio; Walz, Brigitte; Bergner, Michael; Twerenbold, Raphael; Reichlin, Tobias; Zogg, Bernhard; Jaeger, Cedric; Erne, Paul; Müller, Christian (2016). Incremental value of heart-type fatty acid-binding protein in suspected acute myocardial infarction early after symptom onset. European Heart Journal: Acute Cardiovascular Care, 5(2), pp. 185-192. Sage 10.1177/2048872615571256
Full text not available from this repository. (Request a copy)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.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Geriatric Clinic |
UniBE Contributor: |
Schoenenberger, Andreas, Müller, Christian |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2048-8734 |
Publisher: |
Sage |
Language: |
English |
Submitter: |
Rebecca Rufer |
Date Deposited: |
07 Apr 2016 13:14 |
Last Modified: |
05 Dec 2022 14:52 |
Publisher DOI: |
10.1177/2048872615571256 |
PubMed ID: |
25681485 |
URI: |
https://boris.unibe.ch/id/eprint/77271 |
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