Incremental value of heart-type fatty acid-binding protein in suspected acute myocardial infarction early after symptom onset.

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

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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).


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.


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)


04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Geriatric Clinic

UniBE Contributor:

Schoenenberger, Andreas and Müller, Christian


600 Technology > 610 Medicine & health








Rebecca Rufer

Date Deposited:

07 Apr 2016 13:14

Last Modified:

25 Apr 2017 11:34

Publisher DOI:


PubMed ID:



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