Document Detail


Novel biomarkers in early diagnosis of acute myocardial infarction compared with cardiac troponin T.
MedLine Citation:
PMID:  18682444     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To evaluate the role of novel biomarkers in early detection of acute myocardial infarction (MI) in patients admitted with acute chest pain. METHODS AND RESULTS: A prospective study of 664 patients presenting to two coronary care units with chest pain was conducted over 3 years from 2003. Patients were assessed on admission: clinical characteristics, ECG (electrocardiogram), renal function, cardiac troponin T (cTnT), heart fatty acid binding protein (H-FABP), glycogen phosphorylase-BB, NT-pro-brain natriuretic peptide, D-dimer, hsCRP (high sensitivity C-reactive protein), myeloperoxidase, matrix metalloproteinase-9, pregnancy associated plasma protein-A, soluble CD40 ligand. A > or = 12 h cTnT sample was also obtained. MI was defined as cTnT > or = 0.03 microg/L. In patients presenting <4 h of symptom onset, sensitivity of H-FABP for MI was significantly higher than admission cTnT (73 vs. 55%; P = 0.043). Specificity of H-FABP was 71%. None of the other biomarkers challenged cTnT. Combined use of H-FABP and cTnT (either one elevated initially) significantly improved the sensitivities of H-FABP or cTnT (85%; P < or = 0.004). This combined approach also improved the negative predictive value, negative likelihood ratio, and the risk ratio. CONCLUSION: Assessment of H-FABP within the first 4 h of symptoms is superior to cTnT for detection of MI, and is a useful additional biomarker for patients with acute chest pain.
Authors:
Conor J McCann; Ben M Glover; Ian B A Menown; Michael J Moore; Jane McEneny; Colum G Owens; Bernie Smith; Peter C Sharpe; Ian S Young; Jennifer A Adgey
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2008-08-05
Journal Detail:
Title:  European heart journal     Volume:  29     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-02     Completed Date:  2009-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  2843-50     Citation Subset:  IM    
Affiliation:
The Heart Centre, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, Northern Ireland, UK.
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MeSH Terms
Descriptor/Qualifier:
Angina, Unstable / diagnosis*
Biological Markers / metabolism
Chest Pain / etiology
Electrocardiography
Epidemiologic Methods
Fatty Acid-Binding Proteins / metabolism*
Female
Humans
Male
Middle Aged
Myocardial Infarction / diagnosis*
Natriuretic Peptide, Brain / metabolism*
Prognosis
Troponin T / metabolism*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/FABP3 protein, human; 0/Fatty Acid-Binding Proteins; 0/Troponin T; 114471-18-0/Natriuretic Peptide, Brain
Comments/Corrections
Comment In:
Eur Heart J. 2008 Dec;29(23):2827-8   [PMID:  18957473 ]

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