| Heart-type fatty acid binding protein and the diagnosis of acute coronary syndrome in the ED. | |
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MedLine Citation:
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PMID: 22169585 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: In combination with cardiac troponin, heart-type fatty acid binding protein (h-FABP)-a biomarker of myocardial necrosis-offers the possibility of rapidly eliminating the diagnosis of acute myocardial infarction (AMI). OBJECTIVE: The main objective of this study was to assess the incremental value of h-FABP to cardiac troponin for a rapid elimination of AMI, according to the pretest probability (PTP) of AMI. METHODS: In consecutive patients presenting to emergency departments (ED) with chest pain less than 6 hours suggestive of AMI, h-FABP levels were measured, blinded to the ED physicians, who were asked to quote the PTP of AMI. The discharge diagnosis was adjudicated by 2 independent experts, blind to the h-FABP level. RESULTS: Three hundred seventeen patients (mean age of 57 years) were included in whom 149 had (47%) low, 117 (37%) moderate, and 51 (16%) high PTP. The final diagnosis was AMI in 45 patients (14%), including 16 STEMIs (5%). The negative predictive value for diagnostic elimination of AMI of an h-FABP less than 3 μg/L, combined with a negative cTnI was not higher than that of cardiac troponin I (cTnI) alone (96% [95% confidence interval, 93%-98%] vs 95% [93%-98%]), regardless of the PTP). Even in the low-PTP group, we did not demonstrate a significant improvement in negative predictive value with the addition of h-FABP, compare with that of cTnI alone (100% [97%-100%] vs 99% [96%-100%]). CONCLUSION: In triage of patients with chest pain, use of h-FABP does not provide useful additional information to cTnI for excluding the diagnosis of ST-elevation myocardial infarction and non-ST-elevation myocardial infarction diagnosis, whatever the PTP. |
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Authors:
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Yonathan Freund; Camille Chenevier-Gobeaux; François Leumani; Yann-Erick Claessens; Jean-Christophe Allo; Benoit Doumenc; Claudine Cosson; Pascale Bonnet; Bruno Riou; Patrick Ray |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-12 |
Journal Detail:
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Title: The American journal of emergency medicine Volume: - ISSN: 1532-8171 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8309942 Medline TA: Am J Emerg Med Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011. Published by Elsevier Inc. |
Affiliation:
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Department of Emergency Department, Hôpital Pitié-Salpétrière, Assistance Publique-Hôpitaux de Paris, Univ UPMC Paris 6, 75005 Paris, France. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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