| Heart-type fatty acid binding protein as an early marker for myocardial infarction: systematic review and meta-analysis. | |
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MedLine Citation:
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PMID: 22593266 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BackgroundHeart-type fatty acid binding protein (H-FABP) has been proposed as an early biomarker of myocardial infarction (MI). The authors aimed to undertake a systematic review and meta-analysis to estimate the early sensitivity and specificity of quantitative and qualitative H-FABP assays.MethodsThe authors undertook a systematic search using electronic databases, citation lists and expert contacts to identify all diagnostic cohort studies of patients presenting with suspected acute coronary syndrome that compared H-FABP at presentation to a reference standard based on the Universal definition of MI. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. Meta-analysis was conducted using Bayesian Markov chain Monte Carlo simulation.ResultsThe authors included eight studies of quantitative H-FABP and nine studies of qualitative H-FABP. The summary estimates of sensitivity and specificity were 81% (95% prediction interval 50% to 95%) and 80% (26% to 98%) respectively for the quantitative assays and 68% (11% to 97%) and 92% (20% to 100%) respectively for the qualitative assays. Four studies reported the sensitivity of troponin and H-FABP at presentation in which the combination was considered positive if either test was positive. The addition of H-FABP to troponin increased sensitivity from 42-75% to 76-97% but decreased specificity from 94-100% to 65-93%.ConclusionH-FABP has modest sensitivity and specificity for MI at presentation but estimates are subject to substantial uncertainty and primary data are subject to substantial heterogeneity. H-FABP may have a role alongside troponin in improving early sensitivity but comparison with high sensitivity troponin assays is required. |
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Authors:
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Christopher Carroll; Mohamad Al Khalaf; John W Stevens; Joanna Leaviss; Steve Goodacre; Paul O Collinson; Jenny Wang |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-5-16 |
Journal Detail:
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Title: Emergency medicine journal : EMJ Volume: - ISSN: 1472-0213 ISO Abbreviation: - Publication Date: 2012 May |
Date Detail:
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Created Date: 2012-5-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100963089 Medline TA: Emerg Med J Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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School of Health and Related Research, University of Sheffield, Sheffield, UK. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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