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Pavel AL, Kundnani NR, Morariu SI, Tudor A, Man DE, Duda-Seiman DM, Velimirovici DE, Valcovici MD, Calin P, Dragan SR. Importance of H-FABP in Early Diagnosis of Acute Myocardial Infarction. Int J Gen Med 2024; 17:4335-4346. [PMID: 39346631 PMCID: PMC11438469 DOI: 10.2147/ijgm.s476736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 08/20/2024] [Indexed: 10/01/2024] Open
Abstract
Background Over the years, troponins have aced the para-clinical tests for confirming the diagnosis of acute myocardial infarction. However, the rise in their levels is entirely time-dependent, which can cause a delay in the initiation of treatment protocols. Heart fatty acid binding protein (H-FABP) can serve comparatively as a better biological marker for overcoming this flaw of troponins, as it is quickly released into the bloodstream once the myocardial injury occurs due to decreased blood supply. This study aimed to evaluate the usefulness of this marker as well as establish the specificity and sensitivity of testing the H-FABP, if it adds to early diagnosis and can be relied upon in the future. Material and Methods We evaluated 83 patients and their H-FABP levels, along with the standard cardiac markers like hsTni and CK-MB, in patients presenting with symptoms indicating an ongoing coronary event, who had presented to our hospital between August 2020 and June 2021. The patients were divided into two groups: group 1 comprised patients who had first medical contact within 4 hours of the onset of chest pain, and group 2 patients who had first medical contact after 4 hours of the appearance of symptoms. Statistical analysis was performed using MedCalc v20.023, considering statistical significance values of p <0.05. Results for targeted variables are presented using descriptive statistics (mean, standard deviation, range, median, and associated interquartile range) for continuous data, and counts with associated percentages for categorical data. Results H-FABP was found to have better sensitivity and specificity of 89.67 and 95.65 in group 1 patients and 86.73 and 49.84, respectively, in group 2 patients. The other two cardiac biomarkers evaluated had lower values in response to H-FABP in the first 4 hours of presentation. Results for group 2 showed that specificitivity for hsTni is higher than that of H-FABP, that is, 69.98. Conclusion Heart fatty acid binding protein (H-FABP) should be included in the protocol for biochemical evaluation of all patients presenting to the emergency services with a suspicion of possible myocardial infarction. Early detection of this protein can help in effective and timely management of myocardial infarction, thus further decreasing mortality rates and the financial burden on healthcare systems worldwide.
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Affiliation(s)
- Andreea Licuta Pavel
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, 300041, Romania
| | - Nilima Rajpal Kundnani
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, 300041, Romania
- Research Centre of Timisoara Institute of Cardiovascular Diseases, “Victor Babes”University of Medicine and PharmacyTimisoara300310Romania
| | - Stelian I Morariu
- General Medicine Faculty, Vasile Goldiș West University Arad, Arad, 473223, Romania
| | - Anca Tudor
- Department of Functional Science, “Victor Babes” University of Medicine and Pharmacy, Timisoara, 300041, Romania
| | - Dana Emilia Man
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, 300041, Romania
- Research Centre of Timisoara Institute of Cardiovascular Diseases, “Victor Babes”University of Medicine and PharmacyTimisoara300310Romania
| | - Daniel Marius Duda-Seiman
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, 300041, Romania
- Research Centre of Timisoara Institute of Cardiovascular Diseases, “Victor Babes”University of Medicine and PharmacyTimisoara300310Romania
| | - Dana Emilia Velimirovici
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, 300041, Romania
- Research Centre of Timisoara Institute of Cardiovascular Diseases, “Victor Babes”University of Medicine and PharmacyTimisoara300310Romania
| | - Mihaela Daniela Valcovici
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, 300041, Romania
- Research Centre of Timisoara Institute of Cardiovascular Diseases, “Victor Babes”University of Medicine and PharmacyTimisoara300310Romania
| | - Pop Calin
- General Medicine Faculty, Vasile Goldiș West University Arad, Arad, 473223, Romania
- County Emergency Hospital Baia Mare, Baia Mare, Romania
| | - Simona Ruxanda Dragan
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, 300041, Romania
- Research Centre of Timisoara Institute of Cardiovascular Diseases, “Victor Babes”University of Medicine and PharmacyTimisoara300310Romania
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Wu Y, Pan N, An Y, Xu M, Tan L, Zhang L. Diagnostic and Prognostic Biomarkers for Myocardial Infarction. Front Cardiovasc Med 2021; 7:617277. [PMID: 33614740 PMCID: PMC7886815 DOI: 10.3389/fcvm.2020.617277] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 12/29/2020] [Indexed: 01/12/2023] Open
Abstract
The incidence of myocardial infarction (MI) increases every year worldwide. Better diagnostic and prognostic biomarkers for clinical applications are the consistent pursuit of MI research. In addition to electrocardiogram, echocardiography, coronary angiography, etc., circulating biomarkers are essential for the diagnosis, prognosis, and treatment effect monitoring of MI patients. In this review, we assessed both strength and weakness of MI circulating biomarkers including: (1) originated from damaged myocardial tissues including current golden standard cardiac troponin, (2) released from non-myocardial tissues due to MI-induced systems reactions, and (3) preexisted in blood circulation before the occurrence of MI event. We also summarized newly reported MI biomarkers. We proposed that the biomarkers preexisting in blood circulation before MI incidents should be emphasized in research and development for MI prevention in near future.
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Affiliation(s)
- Yuling Wu
- Systems Biology & Medicine Center for Complex Diseases, Center for Clinical Research, Affiliated Hospital of Qingdao University, Qingdao, China.,Department of Cardiology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Nana Pan
- Department of Cardiology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yi An
- Department of Cardiology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Mengyuan Xu
- Department of Cardiology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lijuan Tan
- Department of Cardiology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lijuan Zhang
- Systems Biology & Medicine Center for Complex Diseases, Center for Clinical Research, Affiliated Hospital of Qingdao University, Qingdao, China
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Heart-type fatty acid binding protein (H-FABP) as a biomarker for acute myocardial injury and long-term post-ischemic prognosis. Acta Pharmacol Sin 2018; 39:1155-1163. [PMID: 29770799 DOI: 10.1038/aps.2018.37] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 02/28/2018] [Indexed: 12/11/2022]
Abstract
Acute myocardial infarction (AMI) is a life-threatening event. Even with timely treatment, acute ischemic myocardial injury and ensuing ischemia reperfusion injury (IRI) can still be difficult issues to tackle. Apart from radiological and other auxiliary examinations, laboratory tests of applicable cardiac biomarkers are also necessary for early diagnosis and close monitoring of this disorder. Heart-type fatty acid binding protein (H-FABP), which mainly exists inside cardiomyocytes, has recently emerged as a potentially promising biomarker for myocardial injury. In this review we discuss the sensitivity and specificity of H-FABP in the assessment of myocardial injury and IRI, especially in the early stage, and its long-term prognostic value in comparison with other commonly used cardiac biomarkers, including myoglobin (Mb), cardiac troponin I (cTnI), creatine kinase MB (CK-MB), C-reactive protein (CRP), glycogen phosphorylase isoenzyme BB (GPBB), and high-sensitivity cardiac troponin T (hs-cTnT). The potential and value of combined application of H-FABP with other biomarkers are also discussed. Finally, the prospect of H-FABP is summarized; several technical issues are discussed to facilitate wider application of H-FABP in clinical practice.
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Zhang L, Zhou H, Peng Q, Jiang W, Qiao W, Wang G. Fatty acid binding protein 3 is associated with skeletal muscle strength in polymyositis and dermatomyositis. Int J Rheum Dis 2016; 20:252-260. [PMID: 26891180 DOI: 10.1111/1756-185x.12838] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Lu Zhang
- Department of Rheumatology; China-Japan Friendship Hospital; Beijing China
| | - Hang Zhou
- Department of Rheumatology; Beijing Friendship Hospital Capital Medical University; Beijing China
| | - Qinglin Peng
- Department of Rheumatology; China-Japan Friendship Hospital; Beijing China
| | - Wei Jiang
- Department of Rheumatology; China-Japan Friendship Hospital; Beijing China
| | - Wei Qiao
- Department of Senior Ward; China-Japan Friendship Hospital; Beijing China
| | - Guochun Wang
- Department of Rheumatology; China-Japan Friendship Hospital; Beijing China
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Banu S, Tanveer S, Manjunath CN. Comparative study of high sensitivity troponin T and heart-type fatty acid-binding protein in STEMI patients. Saudi J Biol Sci 2014; 22:56-61. [PMID: 25561884 DOI: 10.1016/j.sjbs.2014.05.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 05/29/2014] [Accepted: 05/29/2014] [Indexed: 10/25/2022] Open
Abstract
AIM AND BACKGROUND Heart-type fatty acid-binding proteins (H-FABP) which are detected within 2-3 h of acute myocardial infarction are involved in uptake of free fatty acids in the myocardium. Our aim in the present study is to compare window periods of H-FABP to high sensitivity troponin T (hs-Trop T) in acute ST elevation myocardial infarction (STEMI). METHODS 160 STEMI diagnosed patient's serum samples are analyzed for hs-Trop T and H-FABP. Different window periods of chest pain onset (<3 h, 3-6 h and >6 h) are compared with complications, in-hospital mortality and statistically analyzed. RESULTS From 160 patients, 53 (33%) cases are presented in <3 h, 75 (47%) in 3-6, and 32 (20%) after >6 h respectively. Accordingly sensitivity of hs-Trop T was 92%, 94% and 97% while H-FABP was 75%, 88% and 84%, respectively. Overall sensitivity was 94% and 82% respectively. Statistically significant difference between mean hs-Trop T values with respect to window period <3, 3-6 and >6 h was 0.21, 0.35 and 0.80 ng/ml respectively, p value < 0.0001. No significant difference in H-FABP values was observed. Hs-Trop T positively correlated with age (r = 0.153, P = 0.05), window period (r = 0.363, P < 0.0001), TIMI score (r = 0.208, P = 0.008), ejection fraction (r = 0.191, P = 0.008), serum H-FABP (r = 0.229, P = 0.004), and serum hs-CRP (r = 0.326, p < 0.001). There was a statistically significant difference of mean hs-Trop T values with or without in hospital mortality (0.35 vs. 0.85 ng/ml, respectively, p = 0.008). No significant correlation to age, TIMI score, ejection fraction and hs-CRP values for H-FABP was observed. CONCLUSION It appears that hs-Trop T is a more sensitive marker than H-FABP in early hours of AMI and higher hs-Trop T predicts increase in-hospital mortality.
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Affiliation(s)
- Shaheena Banu
- Department of Biochemistry, Sri Jayadeva Institute of Cardiovascular Sciences and Research, India
| | - Syed Tanveer
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, India
| | - C N Manjunath
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, India
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Lankeit M, Dellas C, Benz V, Hasenfuß G, Konstantinides S. The predictive value of heart-type fatty acid-binding protein is independent from symptom duration in normotensive patients with pulmonary embolism. Thromb Res 2013; 132:543-7. [PMID: 24094603 DOI: 10.1016/j.thromres.2013.09.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 09/09/2013] [Accepted: 09/17/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Heart-type fatty acid-binding protein (H-FABP) is a useful biomarker for risk stratification of patients with pulmonary embolism (PE). In patients with acute myocardial infarction, H-FABP plasma concentrations rise after 30 minutes and return to normal within 20-24 hours. We tested whether the predictive value of H-FABP is affected by the duration of symptoms prior to diagnosis in patients with PE. MATERIAL AND METHODS We prospectively studied 257 consecutive normotensive patients with confirmed symptomatic PE. RESULTS Patients with acute (<24 hours; n=150) symptom onset presented more often with syncope (28.7% vs. 6.5%; p<0.001) compared to patients with symptoms ≥ 24 hours (n=107); other baseline characteristics, comorbidities, and risk factors were distributed equally. Patients with an adverse 30-day outcome (6.6%) had higher H-FABP levels (11.84 [3.57-19.62] ng/ml) compared to patients with a favorable course (3.42 [1.92-5.42] ng/ml; p<0.001). However, the proportion of patients with H-FABP levels ≥ 6 ng/ml did not differ among patients with acute symptom onset and late presentation (p=0.104). Only tachycardia and elevation of H-FABP were associated with an increased risk of an adverse 30-day outcome both in patients with acute symptom onset (H-FABP: OR, 5.8; 95% CI, 1.4-24.5; p=0.016; tachycardia: 7.0 [1.4-36.0]; p=0.018) and late presentation (H-FABP: 9.3 [2.0-43.2]; p=0.004 and tachycardia: 12.3 [1.5-103.6]; p=0.021). The prognostic value could further be improved by the use of a simple H-FABP-based clinical prediction score. CONCLUSIONS Our findings indicate that H-FABP is a useful biomarker for risk stratification of normotensive patients with PE regardless of symptom duration prior to diagnosis.
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Affiliation(s)
- Mareike Lankeit
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, Johannes Gutenberg University of Mainz, Germany; Department of Cardiology and Pulmonology, Heart Center of the Georg August University of Göttingen, Germany.
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Waks JW, Scirica BM. Established and novel biomarkers in ST-elevation myocardial infarction. Future Cardiol 2011; 7:523-46. [PMID: 21797748 DOI: 10.2217/fca.11.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Cardiac biomarkers assist in the diagnosis of and risk stratification in acute coronary syndromes. In ST-elevation myocardial infarction (STEMI), rapid diagnosis and initiation of reperfusion via primary percutaneous coronary intervention or fibrinolysis is often based on the clinical history and presenting ECG, but measurement of biomarkers in the early and/or late phases of STEMI may allow the selection of patients who are at increased or decreased risk of subsequent complications. Although the measurement of only three biomarkers (troponin, natriuretic peptides and C-reactive protein) are currently included in practice guidelines, more than 20 other novel cardiac biomarkers have been proposed to provide improved risk stratification after a STEMI.
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Affiliation(s)
- Jonathan W Waks
- Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
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Sbarouni E, Georgiadou P, Sklavainas I, Chaidaroglou A, Panagiotakos D, Degiannis D, Voudris V. Increases in serum concentration of human heart-type fatty acid-binding protein following elective coronary intervention. Biomarkers 2009; 14:317-20. [PMID: 19552571 DOI: 10.1080/13547500902887530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Heart-type fatty acid-binding protein (H-FABP) is considered a marker of myocardial necrosis but whether or not it is modified by myocardial ischemia is not clear. We sought to investigate if H-FABP serum levels increase following non-urgent coronary angioplasty. METHODS We studied 31 patients undergoing coronary angioplasty. Peripheral venous samples were drawn immediately before angioplasty, 1 h after the first balloon inflation and 24 h after the procedure and assayed for H-FABP. RESULTS Serum levels of H-FABP increased significantly at 1 h vs baseline from 2554 +/- 1268 to 3322 +/- 245 pg ml(-1) (p = 0.024). However, no differences were observed between 1 h and 24 h after angioplasty (3268 +/- 1861 vs 3322 +/- 2459 pg ml(-1), p = 0.87). Moreover, no significant difference was observed when we compared 24 h after angioplasty with the baseline (3268 +/- 1861 vs 2554 +/- 1268 pg ml(-1), p = 0.112). CONCLUSIONS We conclude that H-FABP significantly increases after elective coronary angioplasty at 1 h compared with baseline values; whether or not this has any prognostic significance for future events, as it occurs with troponins, needs to be studied further.
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Affiliation(s)
- Eftihia Sbarouni
- Second Department of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece.
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Dominguez-Rodriguez A, Kaski JC, Abreu-Gonzalez P, Samimi-Fard S. Role of ischemia modified albumin to ST-segment resolution after mechanical reperfusion in patients with ST-segment elevation myocardial infarction. Atherosclerosis 2009; 203:576-80. [DOI: 10.1016/j.atherosclerosis.2008.07.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2008] [Revised: 07/04/2008] [Accepted: 07/21/2008] [Indexed: 10/21/2022]
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Abstract
Early diagnosis of acute coronary syndromes (ACS) allows for efficient risk stratification, appropriate targeted therapies, and faster patient disposition within crowded emergency departments. Although only troponin testing is recommended for routine use in the 2007 American College of Cardiology/American Heart Association guidelines for non-ST-elevation ACS, emerging data support selected use of other biomarkers, including B-type natriuretic peptides (BNPs) and C-reactive protein. There remains a need to identify additional biomarkers in ACS to enhance risk stratification and to help guide therapeutic decisions in this increasingly complex area of cardiovascular medicine. Cardiac biomarkers may help to diagnosis ACS before cardiomyocyte necrosis, to influence the decision for early invasive treatment, and to provide a means of monitoring response to therapy. In this review, we assess new data in ACS with respect to troponins, BNPs, myeloperoxidase, fatty acid-binding protein, and monocyte chemoattractant protein-1. We also discuss novel biomarkers including growth deficient factor-15 and neopterin.
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de Lemos JA, O’Donoghue M. The Skinny on Fatty Acid-Binding Protein⁎⁎Editorials published in the Journal of American College of Cardiologyreflect the views of the authors and do not necessarily represent the views of JACCor the American College of Cardiology. J Am Coll Cardiol 2007; 50:2068-70. [DOI: 10.1016/j.jacc.2007.07.072] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2007] [Accepted: 07/17/2007] [Indexed: 10/22/2022]
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O'Donoghue M, de Lemos JA, Morrow DA, Murphy SA, Buros JL, Cannon CP, Sabatine MS. Prognostic utility of heart-type fatty acid binding protein in patients with acute coronary syndromes. Circulation 2006; 114:550-7. [PMID: 16880323 DOI: 10.1161/circulationaha.106.641936] [Citation(s) in RCA: 120] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Heart-type fatty acid binding protein (H-FABP) is a cytosolic protein that is released rapidly from the cardiomyocyte in response to myocardial injury. Although it has been investigated as an early marker of acute myocardial infarction, its prognostic utility in acute coronary syndromes has not been established. METHODS AND RESULTS We measured H-FABP in 2287 patients with acute coronary syndromes from the OPUS-TIMI 16 trial. H-FABP was elevated (> 8 ng/mL) in 332 patients (14.5%). Patients with an elevated H-FABP were more likely to suffer death (hazard ratio [HR], 4.1; 95% CI, 2.6 to 6.5), recurrent myocardial infarction (HR, 1.6; 95% CI, 1.0 to 2.5), congestive heart failure (HR, 4.5; 95% CI, 2.6 to 7.8), or the composite of these end points (HR, 2.6; 95% CI, 1.9 to 3.5) through the 10-month follow-up period. H-FABP predicted the risk of the composite end point both in patients who were troponin I negative (HR, 2.1; 95% CI, 1.3 to 3.4) and in those who were troponin I positive (HR, 3.3; 95% CI, 2.0 to 5.3). In a Cox proportional-hazards model that adjusted for baseline variables, including demographics, clinical characteristics, creatinine clearance, ST deviation, index diagnosis, and troponin I, elevated H-FABP remained a significant predictor of the composite end point (HR, 1.9; 95% CI, 1.3 to 2.7), as well as the individual end points of death (HR, 2.7; 95% CI, 1.5 to 4.9) and CHF (HR, 2.4; 95% CI, 1.2 to 5.0). In a multimarker approach, H-FABP, troponin I, and B-type natriuretic peptide provided complementary information. CONCLUSIONS Elevation of H-FABP is associated with an increased risk of death and major cardiac events in patients presenting across the spectrum of acute coronary syndromes and is independent of other established clinical risk predictors and biomarkers.
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Affiliation(s)
- Michelle O'Donoghue
- Cardiovascular Division, Brigham and Women's Hospital, 350 Longwood Ave, First Floor, Boston, Mass 02115, USA
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Azzazy HME, Pelsers MMAL, Christenson RH. Unbound Free Fatty Acids and Heart-Type Fatty Acid–Binding Protein: Diagnostic Assays and Clinical Applications. Clin Chem 2006; 52:19-29. [PMID: 16269514 DOI: 10.1373/clinchem.2005.056143] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackground: A biomarker that reliably detects myocardial ischemia in the absence of necrosis would be useful for initial identification of unstable angina patients and for differentiating patients with chest pain of an etiology other than coronary ischemia, and could provide clinical utility complementary to that of cardiac troponins, the established markers of necrosis. Unbound free fatty acids (FFAu) and their intracellular binding protein, heart-type fatty acid–binding protein (H-FABP), have been suggested to have clinical utility as indicators of cardiac ischemia and necrosis, respectively.Methods: We examined results of clinical assessments of FFAu and H-FABP as biomarkers of cardiac ischemia and necrosis. Data published on FFAu and H-FABP over the past 30 years were used as the basis for this review.Results: Although little clinical work has been done on FFAu since the initial reports, recent studies documented an association between increased serum FFAs and ventricular dysrhythmias and death in patients with acute myocardial infarction (AMI). Recent data suggest that serum FFAu concentrations increase well before markers of cardiac necrosis and are sensitive indicators of ischemia in AMI. H-FABP is abundant in cardiac muscle and is presumed to be involved in myocardial lipid homeostasis. Similar to myoglobin, plasma H-FABP increases within 3 h after AMI and returns to reference values within 12–24 h.Conclusions: FFAu may have a potential role in identifying patients with cardiac ischemia. H-FABP is useful for detecting cardiac injury in acute coronary syndromes and predicting recurrent cardiac events in acute coronary syndromes and in congestive heart failure patients. Assays are available for both markers that could facilitate further clinical investigations to assess their possible roles as markers of cardiac ischemia and/or necrosis.
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Affiliation(s)
- Hassan M E Azzazy
- Department of Chemistry and Science & Technology Research Center, School of Science and Engineering, The American University in Cairo, Cairo, Egypt.
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Liu H, Dong GH, Xu B, Shen Y, Jing H. Heart fatty acid binding protein in the rapid evaluation of myocardial damage following valve replacement surgery. Clin Chim Acta 2005; 356:147-53. [PMID: 15936311 DOI: 10.1016/j.cccn.2005.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2005] [Revised: 01/12/2005] [Accepted: 01/12/2005] [Indexed: 11/28/2022]
Abstract
BACKGROUND Myocardial damage occurs following valve replacement surgery. We estimated the value of heart fatty acid binding protein (H-FABP) in these patients. METHODS Sixty elected patients were enrolled and distributed into single (group A) and double (group B) valve replacement groups. The clinical data were outlined and blood samples were collected perioperatively for determination of plasma levels of H-FABP, cardiac troponin-I (cTn-I), and CK-MB in both groups. RESULTS 56 patients completed the study and no significant difference of clinical data was observed except CPB time and ACC time between groups. H-FABP level elevated quickly after reperfusion and peaked significantly earlier than cTn-I and CK-MB, it also declined rapidly but did not return to baseline at 24 h after reperfusion. Three markers' levels were all higher in group B than in group A after reperfusion with significant differences at their peaks and thereafter. Patients with postoperative complications had significantly higher H-FABP levels than usual. H-FABP peak level associated well with the length of CPB and ACC as well as with other 2 markers' peak levels in both groups. CONCLUSION Compared with cTn-I and CK-MB, H-FABP is an earlier and potentially useful marker in the rapid evaluation of myocardial damage following valve replacement surgery with CPB.
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Affiliation(s)
- Hong Liu
- Department of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing 210002, P.R. China.
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Pelsers MMAL, Hermens WT, Glatz JFC. Fatty acid-binding proteins as plasma markers of tissue injury. Clin Chim Acta 2005; 352:15-35. [PMID: 15653098 DOI: 10.1016/j.cccn.2004.09.001] [Citation(s) in RCA: 341] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2004] [Revised: 09/07/2004] [Accepted: 09/10/2004] [Indexed: 12/13/2022]
Abstract
BACKGROUND One of the novel and promising plasma markers for detection of tissue injury is the family of 15 kDa cytoplasmic fatty acid-binding proteins of which various tissue-specific types occur. AIMS AND OBJECTIVES The present status of heart-type fatty acid-binding protein (H-FABP) as a diagnostic and prognostic marker for acute and chronic cardiac injury, as well as the preliminary diagnostic use of other types of FABP for detecting injury in other organs, is reviewed. METHODS This review is based on an overview of the literature on clinical diagnostics of various forms of organ injury, and uses additional literature on physiological aspects relevant for the interpretation of plasma marker concentrations. RESULTS H-FABP not only proves to be an excellent early marker for cardiac injury in acute coronary syndromes, but also allows detection of minor myocardial injury in heart failure and unstable angina. Preliminary results indicate that sensitivity, rule-out power and prognostic value of H-FABP in cardiac injury surpass the performance of the standard early marker myoglobin. The liver only contains liver-type FABP (L-FABP), but co-expression of H-FABP and L-FABP occurs in the kidney. Similarly, intestinal-type FABP (I-FABP) and L-FABP are found in intestines, and brain-type FABP (B-FABP) and H-FABP occur in the brain. Preliminary but promising applications of these proteins have been demonstrated for liver rejection, viability selection of kidneys from non-heart-beating donors (NHBD), inflammatory and ischemic bowel disease, traumatic brain injury and in the prevention of muscle injury in trained athletes. CONCLUSIONS Further study of the diagnostic and prognostic use of various FABP types is warranted, but their clinical application will require further commercialization of automated and rapid assays.
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Affiliation(s)
- Maurice M A L Pelsers
- Department of Molecular Genetics, Cardiovascular Research Institute Maastricht, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
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Lescuyer P, Allard L, Hochstrasser DF, Sanchez JC. Heart-Fatty Acid-Binding Protein as a Marker for Early Detection of Acute Myocardial Infarction and Stroke. ACTA ACUST UNITED AC 2005; 9:1-7. [PMID: 16035729 DOI: 10.2165/00066982-200509010-00001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Heart-fatty acid-binding protein (H-FABP) is a small cytosolic protein involved in intracellular fatty acid transport. This protein, highly concentrated in the heart, is quickly released into plasma after myocardial injury. Results from numerous studies suggest that H-FABP is an excellent marker for the early detection of myocardial damage. H-FABP is also expressed in the brain, although in lower concentrations than in the heart. Recent preliminary studies also investigated the usefulness of H-FABP for the diagnosis of acute and chronic neurological disorders. These potential applications of H-FABP in clinical practice are reviewed in this article, with a strong focus on the early diagnosis of acute myocardial infarction and stroke.
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Affiliation(s)
- Pierre Lescuyer
- Department of Bioinformatics and Structural Biology, Biomedical Proteomics Research Group, Geneva University, Geneva, Switzerland.
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Abstract
Rapid, simple and inexpensive measures are needed to assess the efficacy of reperfusion therapy both in clinical practice and in clinical trials testing novel reperfusion regimens. In the last decade, several observations have led to a favorable reappraisal of the utility of ST segment monitoring as a simple means of assessing reperfusion in patients receiving fibrinolytic therapy for acute ST elevation myocardial infarction, and ST resolution is being used increasingly in clinical practice and in clinical research. This review focuses on four interrelated roles for ST segment monitoring: the assessment of epicardial reperfusion and the identification of candidates for rescue percutaneous coronary intervention; the evaluation of microvascular and tissue-level reperfusion; the determination of prognosis early after fibrinolytic therapy; and the use of ST segment resolution to compare different reperfusion regimens.
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Affiliation(s)
- J A de Lemos
- Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center, Dallas, Texas 75093-9034, USA.
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