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Article Type

Original Study

Abstract

Objective To determine the role of heart-type fatty acid-binding protein (h-FABP type III) as a diagnostic biomarker in acute coronary syndrome in the early detection of myocardial ischemia or myocardial necrosis (30 min to 6 h from onset of chest pain). Background Cardiac biomarkers play an important role in the diagnosis of acute coronary syndrome. Cardiac troponins have been the preferred biomarker, but because of their delayed appearance in the serum, there is still a need for reliable. h-FABP, a small (15 kDa) cytoplasmic tissue-specific protein, is mainly expressed by cardiac biomarkers. Methods and results The patients were classified into two main groups. Group I included patients who presented with ST-segment elevation myocardial infarction (STEMI, n = 25) and group II included patients who presented with non-STEMI/unstable angina (NSTEMI/UA, n = 25) within 20 min and 6 h of acute chest pain. Blood h-FABP levels were measured using a QuickSens test (semiqualitiative) and were compared with first cTn-I and creatine kinase-MB at the time of admission and second troponin 12 h from onset of chest pain. Then, according to the serum level of h-FABP, the patients were classified into two subgroups: h-FABP-positive patients and h-FABP-negative patients. The diagnostic sensitivity, specificity, and receiver operating characteristic curve were evaluated. Serum h-FABP was significantly elevated within 20 min to 6 h. In terms of the relation between h-FABP and second troponin, h-FABP showed a sensitivity of 92.59%, a specificity of 52.17%, a positive predictive value of 69.44%, a negative predictive value of 85.71%, and an accuracy of 74%. Our results showed that h-FABP was significantly higher than other biomarkers less than 6 h after the onset of chest pain. Conclusion h-FABP can be used as an early diagnostic cardiac biomarker in the early detection of patients with an acute coronary syndrome within 30 min to 6 h of onset of chest pain.

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