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Abstract

Background: Timely identification of acute myocardial infarction (AMI) plays a vital role in ensuring prompt treatment and better clinical outcomes. Traditional cardiac indicators involving creatine kinase-myocardial band (CK-MB) and cardiac troponin I (cTnI) demonstrate reduced diagnostic accuracy through the initial hours after symptom presentation.

Aim: This research aimed to assess the diagnostic accuracy of heart-type fatty acid-binding protein (H-FABP) in comparison with cTnI, CK-MB, and lactate dehydrogenase (LDH) among cases presenting with acute chest pain, with particular focus on its role in early AMI detection.

Methods: A case-control investigation was conducted involving 60 AMI patients from the National Heart Institute alongside 60 age- and sex-matched healthy individuals serving as controls. AMI diagnosis followed the Fourth Universal Definition of Myocardial Infarction guidelines. Patient classification has been based on chest pain duration: Group 1 (≤4 hours, n=30) and Group 2 (>4 hours, n=30). All participants underwent clinical assessment, 12-lead electrocardiography, and measurement of CK-MB, cTnI, H-FABP, and LDH. Data analysis has been performed utilizing IBM SPSS version 22.0 and MedCalc Statistical Software version 20.0. Non-parametric comparisons utilized Mann-Whitney U test, correlations have been evaluated utilizing Spearman coefficient, and diagnostic performance has been assessed through receiver operating characteristic (ROC) curve analysis.

Results: Cardiac biomarker concentrations were markedly elevated in AMI patients versus controls (p3.4 ng/mL, H-FABP achieved 95.0% sensitivity and 100% specificity. Troponin I also showed excellent performance (AUC=0.978, ninety-five percent CI: 0.934–0.996), while CK-MB demonstrated good but lower accuracy (AUC=0.901, ninety-five percent CI: 0.833–0.948).

Conclusion: H-FABP represents a highly accurate early biomarker for AMI detection, particularly within the 1st four hours following symptom onset, providing comparable diagnostic value to troponin I and superior performance compared with CK-MB.

Article Type

Original Study

Subject Area

Clinical and Chemical Pathology

IRB Number

IHc00146

Creative Commons License

Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

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