Heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction: a systematic review and meta-analysis

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#aged #biomarkers #early-diagnosis #fatty-acid-binding-protein-3 #fatty-acid-binding-proteins

Heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction: a systematic review and meta-analysis

Bruins et al., 2010 | Heart | Meta Analysis

Citation

Bruins Slot Madeleine H E, Reitsma J B, ... van der Heijden Geert J M G. Heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction: a systematic review and meta-analysis. Heart. 2010-Dec;96(24):1957-63. doi:10.1136/hrt.2010.208272

Abstract

OBJECTIVE: To determine the accuracy of heart-type fatty acid-binding protein (H-FABP) as a new and early cardiac biomarker in the early diagnosis of acute myocardial infarction (AMI). The introduction of early and safe biomarkers could lead to (a) a large reduction in unnecessary hospital referrals of patients suspected of, but not, having AMI and (b) an earlier start of treatment in patients with AMI. DESIGN: Diagnostic meta-analysis. SETTING: Hospital and pre-hospital. PATIENTS: Consecutive patients suspected of having AMI. MAIN OUTCOME MEASURES: A summary estimate for sensitivity and specificity was calculated using the bivariate random-effects approach, and covariate analysis was used to examine sources of heterogeneity between studies. RESULTS: A systematic search yielded 16 studies (3709 patients, prevalence of AMI 13-74%, male gender 49-84%, median age 64-76 years). The summary estimate was 84% (95% CI 76% to 90%) for sensitivity and 84% (95% CI 76% to 89%) for specificity. Covariate analyses revealed that the use of troponin in the reference standard for AMI (as opposed to creatine kinase or creatine kinase-myocardial band) had a significant impact on sensitivity. CONCLUSION: H-FABP does not fulfil the requirements needed for a safe and early diagnosis of AMI when used as a stand-alone test. Sound diagnostic studies examining the additional role of H-FABP combined with clinical findings and other diagnostic tests are needed to further clarify a potential future role for this cardiac biomarker.

Key Findings

A systematic search yielded 16 studies (3709 patients, prevalence of AMI 13-74%, male gender 49-84%, median age 64-76 years). The summary estimate was 84% (95% CI 76% to 90%) for sensitivity and 84% (95% CI 76% to 89%) for specificity. Covariate analyses revealed that the use of troponin in the reference standard for AMI (as opposed to creatine kinase or creatine kinase-myocardial band) had a significant impact on sensitivity.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population ami
Sample Size 3709
Age Range age 64-76
Condition See abstract

MeSH Terms

  • Aged
  • Biomarkers
  • Early Diagnosis
  • Fatty Acid Binding Protein 3
  • Fatty Acid-Binding Proteins
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction
  • ROC Curve
  • Sensitivity and Specificity

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: creatine

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09