Document Detail


Heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction: a systematic review and meta-analysis.
MedLine Citation:
PMID:  21088120     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Madeleine H E Bruins Slot; J B Reitsma; Frans H Rutten; Arno W Hoes; Geert J M G van der Heijden
Publication Detail:
Type:  Journal Article; Meta-Analysis; Review    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  96     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-22     Completed Date:  2011-01-27     Revised Date:  2011-04-14    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1957-63     Citation Subset:  AIM; IM    
Affiliation:
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, GA Utrecht, The Netherlands. m.h.e.bruinsslot@umcutrecht.nl
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Biological Markers / blood
Early Diagnosis
Fatty Acid-Binding Proteins / blood*
Female
Humans
Male
Middle Aged
Myocardial Infarction / diagnosis*
ROC Curve
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Biological Markers; 0/FABP3 protein, human; 0/Fatty Acid-Binding Proteins
Comments/Corrections
Comment In:
Heart. 2011 Apr;97(7):605; author reply 605   [PMID:  21378015 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Boxing training for patients with Parkinson disease: a case series.
Next Document:  Insights into genotype-phenotype correlation in hypertrophic cardiomyopathy. Findings from 18 Spanis...