A heart fatty acid binding protein the diagnosis and prognosis of acute coronary syndrome: new possibilities or lost illusions


V.A. Kokorin

Pirogov Russian National Research Medical University, Moscow
The article discusses the current situation with the diagnostic and prognostic value of evaluation of heart type fatty acids binding protein (hFABP), a marker of damage and necrosis of myocardium, in patients with suspected acute coronary syndrome (ACS). The data of comparison of hFABP with currently more common biomarkers is provided. The possibilities of a multimarker approach, including the evaluation of hFABP, for the diagnosis or exclusion of various forms of ACS is analyzing. Special attention is paid to the Russian experience of application of point of care express-tests for the qualitative detection of hFABP in inpatient and outpatient medical care. The obtained high characteristics of such tests allow to recommend it for more wide application in clinical practice, especially in the early periods of ACS. Further studies will more accurately determine the value of hFABP in the diagnosis and prognosis of ACS.
Keywords: heart type fatty acids binding protein, prediction of outcomes, early diagnosis, acute coronary syndrome
Read entire article

Literature

  • Здравоохранение в России. 2017: Стат. сб. / Росстат. М., 2017. 170 с. [1. Здравоохранение в России. 2017: Стат. сб. / Росстат. - М., 2017. – 170 с. [Healthcare in Russia. 2017:Stat. compil. - M., 2017. - p. 170.]
  • Thygesen K., Alpert J.S., Jaffe A.S. et al. Third Universal Definition of Myocardial Infarction. Eur Heart J. 2012;33:2551–67.
  • Kleine A.H., Glatz J.F., van Nieuwenhoven F.A. et al. Release of heart fatty acid-binding protein after acute myocardial infarction in man. Mol Cell Biochem 1992; 116:155-162.
  • Hamm C.W., Bassand J.-P., Agewall S. et al. Guidelines for the management of acute coronary syndromes (ACS) in patients presenting without peristent ST segment elevation. Eur Heart J. 2011;32:2999-3054.
  • Ishii J., Wang J. H., Naruse H. et al. Serum concentrations of myoglobin vs human heart-type cytoplasmic fatty acid-binding protein in early detection of acute myocardial infarction. Clin Chem. 1997;43(8 Pt 1):1372-8.
  • Okamoto F., Sohmiya K., Ohkaru Y. et al. Human heart-type cytoplasmic fatty acid-binding protein (H-FABP) for the diagnosis of acute myocardial infarction. Clinical evaluation of H-FABP in comparison with myoglobin and creatine kinase isoenzyme MB. Clin Chem Lab Med. 2000;38(3):231-8.
  • Chan C.P., Sanderson J.E., Glatz J.F. et al. A superior early myocardial infarction marker. Human heart-type fatty acid-binding protein. Z Kardiol. 2004;93(5):388-97.
  • McCann C.J., Glover B.M., Menown I.B. et al. Novel biomarkers in early diagnosis of acute myocardial infarction compared with cardiac troponin T. Eur Heart J. 2008; 29(23):2843-2850.
  • Body R., McDowell G., Carley S. et al. A FABP-ulous ‘rule out’ strategy? Heart fatty acid binding protein and troponin for rapid exclusion of acute myocardial infarction. Resuscitation. 2011;82(8):1041-6.
  • McMahon C.G., Lamont J.V., Curtin E. et al. Diagnostic accuracy of heart-type fatty acid-binding protein for the early diagnosis of acute myocardial infarction. Am J Emerg Med. 2012;30(2):267-74.
  • Pyati A.K., Devaranavadagi B.B., Sajjannar S.L. et al. Heart-type fatty acid binding protein: a better cardiac biomarker than CK-MB and myoglobin in the early diagnosis of acute myocardial infarction. J Clin Diagn Res. 2015;9(10):BC08-11.
  • Vupputuri A., Sekhar S., Krishnan S. et al. Heart-type fatty acid-binding protein (H-FABP) as an early diagnostic biomarker in patients with acute chest pain. Indian Heart J. 2015;67(6):538-42.
  • Kabekkodu S.P., Mananje S.R., Saya R.P. A study on the role of heart type fatty acid binding protein in the diagnosis of acute myocardial infarction. J Clin Diagn Res. 2016;10(1):OC07-10.
  • Cubranic Z., Madzar Z., Matijevic S. et al. Diagnostic accuracy of heart fatty acid binding protein (H-FABP) and glycogen phosphorylase isoenzyme BB (GPBB) in diagnosis of acute myocardial infarction in patients with acute coronary syndrome. Biochem Med (Zagreb). 2012;22(2):225-36.
  • Charpentier S., Maupas-Schwalm F., Cournot M. et al. Diagnostic accuracy of quantitative heart-fatty acid binding protein assays compared with CardioDetect in the early detection of acute coronary syndrome. Arch. Cardiovasc Dis. 2011;104(10):524-9.
  • Chandran P.A., Wani B.A., Satish O.S. et al. Diagnosis of non-ST-elevation acute coronary syndrome by the measurement of heart-type fatty acid binding protein in serum: a prospective case control study. J Biomark. 2014;2014:624930.
  • Inoue K., Suwa S., Ohta H. et al. Heart fatty acid-binding protein offers similar diagnostic performance to high-sensitivity troponin T in emergency room patients presenting with chest pain. Circ J. 2011;75(12):2813-20.
  • Cappellini F., Da Molin S., Signorini S. et al. Heart-type fatty acid-binding protein may exclude acute myocardial infarction on admission to emergency department for chest pain. Acute Card Care. 2013;15(4):83-7.
  • Uitterdijk A., Sneep S., van Duin R.W. et al. Serial measurement of hFABP and high-sensitivity troponin I post-PCI in STEMI: how fast and accurate can myocardial infarct size and no-reflow be predicted? Am J Physiol Heart Circ Physiol. 2013;305(7):H1104-10.
  • Kellens S., Verbrugge F.H., Vanmechelen M. et al. Point-of-care heart-type fatty acid binding protein versus high-sensitivity troponin T testing in emergency patients at high risk for acute coronary syndrome. Eur Heart J Acute Cardiovasc Care. 2016;5(2):177-84.
  • Keller T., Zeller T., Ojeda F.M. et al. Serial changes in highly sensitive troponin I assays and early diagnosis of myocardial infarction. J Am Med Assoc. 2011;306:2684–93.
  • Willemsen R.T., van Severen E., Vandervoort P.M. et al. Heart-type fatty acid binding protein (H-FABP) in patients in an emergency department setting, suspected of acute coronary syndrome: optimal cut-off point, diagnostic value and future opportunities in primary care. Eur J Gen Pract. 2015;21(3):156-63.
  • Zeren G., Erer H.B., Kırış T. et al. Relation of heart-type fatty acid-binding protein with the degree and extent of atherosclerosis in patients with non-ST elevation acute coronary syndrome. Turk Kardiyol Dern Ars. 2013;41(7):610-6.
  • Kitamura M., Hata N., Takayama T. et al. Different characteristics of cardiac biomarkers to decide and predict the culprit lesions in patients with suspicious acute coronary syndrome. Heart Vessels. 2016;31(6):907-17.
  • Carroll C., Al Khalaf M., Stevens J.W. et al. Heart-type fatty acid binding protein as an early marker for myocardial infarction: systematic review and meta-analysis. Emerg Med J. 2013;30(4):280-6.
  • Lippi G., Mattiuzzi C., Cervellin G. Critical review and meta-analysis on the combination of heart-type fatty acid binding protein (H-FABP) and troponin for early diagnosis of acute myocardial infarction. Clin Biochem. 2013;46(1-2):26-30.
  • Xu L.Q., Yang Y.M., Tong H. et al. Early diagnostic performance of heart-type fatty acid binding protein in suspected acute myocardial infarction: evidence from a meta-analysis of contemporary studies. Heart Lung Circ. 2017; doi: 10.1016/j.hlc.2017.03.165.
  • Figiel L., Wraga M., Bednarkiewicz Z. et al. Direct comparison of the diagnostic value of point-of-care tests detecting heart-type fatty acid binding protein or glycogen phosphorylase isoenzyme BB in patients with acute coronary syndromes with persistent ST-segment elevation. Kardiol. Pol. 2011;69(1):1-6.
  • Gerede D.M., Güleç S., Kiliçkap M. et al. Comparison of a qualitative measurement of heart-type fatty acid-binding protein with other cardiac markers as an early diagnostic marker in the diagnosis of non-ST-segment elevation myocardial infarction. Cardiovasc J Afr. 2015;26(6):204-9.
  • El Missiri A., Okasha N., Badr T. Heart-type fatty acid-binding protein detects more patients with non-ST segment elevation myocardial infarction compared to troponin-T. Egypt Heart J. 2016;68(1):11-6.
  • Hamza M., Demerdash S., Ibrahim M. Heart-type fatty acid-binding protein as a diagnostic biochemical marker for early detection of myocardial infarction. Acta Cardiol. 2016;71(5):537-41.
  • Abbasi W.A., Saleem M., Rasheed S. et al. Utility of heart type fatty acid binding protein (H-FABP) point of care test in the early hours of STEMI compared with troponin-I in Pakistani population. J Ayub Med Coll Abbottabad. 2017;29(1):107-111.
  • Bruins Slot M.H., Rutten F.H., van der Heijden G.J. et al. Diagnostic value of a heart-type fatty acid-binding protein (H-FABP) bedside test in suspected acute coronary syndrome in primary care. Int J Cardiol. 2013;168(2):1485-9.
  • Willemsen R.T., van Severen E., Vandervoort P.M. et al. Heart-type fatty acid binding protein (H-FABP) in patients in an emergency department setting, suspected of acute coronary syndrome: optimal cut-off point, diagnostic value and future opportunities in primary care. Eur J Gen Pract. 2015;21(3):156-63.
  • Кокорин В.А. Российский опыт качественного определения содержания сердечного белка, связывающего жирные кислоты, для ранней диагностики инфаркта миокарда. Фарматека. 2017;10(343):39-44. [Kokorin V.A. Russian experience of qualitative determination of heart-type fatty acid-binding protein concentrations for early diagnostics of myocardial infarction. Pharmateca. 2017;10(343):39-44.]
  • Мартынов А.И., Воевода М.И., Арутюнов Г.П. и др. Клиническая эффективность ранней диагностики острого инфаркта миокарда с помощью белка, связывающего жирные кислоты. Российский кардиологический журнал, 2012;3:7-11. [Martynov A.I., Voevoda M.I., Arutyunov G.P. et al. Clinical effectiveness of early acute myocardial infarction diagnostics, based on the assessment of cardiac fatty acid binding protein levels. Russian Journal of Cardiology. 2012;3:7-11.]
  • Ярохно Н.Н., Большакова И.А., Балабушевич А.В. и др. Оценка эффективности ранней стратификации риска с применением сердечного белка, связывающего жирные кислоты, у больных с подозрением на острый коронарный синдром без подъема сегмента ST в условиях скорой медицинской помощи. Врач скорой помощи. 2013;6:21-25. [Yarohno N.N., Bolshakova I.A., Balabushevich A.V. et al. Assessment of the effectiveness of early risk stratification using a new cardiac marker — heart protein, fatty acid binding, in patients with suspected acute coronary syndrome without ST-segment elevation. Doctor of ambulance care. 2013;6:21-25.]
  • Плавунов Н.Ф., Кадышев В.А., Соколов А.Ю. и др. Апробация теста «КардиоБСЖК» в практике скорой медицинской помощи при дифференциальной диагностике острого коронарного синдрома. Скорая медицинская помощь. 2014;4:31-36. [Plavunov N.F., Kadyshev V.A., Sokolov A.Yu. et al. Approbation of the express-test «CardioFABP» in practice of the emergency medical service for the differential diagnosis of acute coronary syndrome. Emergency medical care. 2014;4:31-36.]
  • Jacobs L.H., van Borren M., Gemen E. et al. Rapidly rule out acute myocardial infarction by combining copeptin and heart-type fatty acid-binding protein with cardiac troponin. Ann Clin Biochem. 2015;52(Pt 5):550-61.
  • Banu S., Tanveer S., Manjunath C.N. Comparative study of high sensitivity troponin T and heart-type fatty acid-binding protein in STEMI patients. Saudi J Biol Sci. 2015;22(1):56-61.
  • Collinson P.O., Gaze D.C., Thokala P. et al. Randomised assessment of treatment using panel assay of cardiac markers - contemporary biomarker evaluation (RATPAC CBE). Health Technol Assess. 2013;17(15):V-VI, 1-122.
  • Gami B.N., Patel D.S., Haridas N. et al. Utility of heart-type fatty acid binding protein as a new biochemical marker for the early diagnosis of acute coronary syndrome. J Clin Diagn Res. 2015;9(1):BC22-4.
  • Reddy L.L., Shah S.A., Dherai A.J. et al. Troponin T and heart type fatty acid binding protein (H-FABP) as biomarkers in patients presenting with chest pain. Indian J Clin Biochem. 2016;31(1):87-92.
  • Schoenenberger A.W., Stallone F., Walz B. et al. Incremental value of heart-type fatty acid-binding protein in suspected acute myocardial infarction early after symptom onset. Eur Heart J Acute Cardiovasc Care. 2016;5(2):185-92.
  • Banu K.Y., Niyazi O.D., Erdem C. et al. Value of heart-type fatty acid-binding protein (H-FABP) for emergency department patients with suspected acute coronary syndrome. Afr Health Sci. 2014;14(3):757-62.
  • Liou K., Ho S., Ooi S.Y. Heart-type fatty acid binding protein in early diagnosis of myocardial infarction in the era of high-sensitivity troponin: a systematic review and meta-analysis. Ann Clin Biochem. 2015;52(Pt 3):370-81.
  • Dupuy A.M., Cristol J.P., Kuster N. et al. Performances of the heart fatty acid protein assay for the rapid diagnosis of acute myocardial infarction in ED patients. Am J Emerg Med. 2015;33(3):326-30.
  • Young J.M., Pickering J.W., George P.M. et al. Heart fatty acid binding protein and cardiac troponin: development of an optimal rule-out strategy for acute myocardial infarction. BMC Emerg Med. 2016;16(1):34.
  • Body R., Dixon D., Burrows G. et al. Economic evaluation of a heart-type fatty acid binding protein based protocol for rapid chest pain assessment. 14th International Conference on Emergency Medicine. Acad Emerg Med. 2012;19(6):746-7.
  • O’Donoghue M., de Lemos J.A., Morrow D.A. et al. Prognostic utility of heart-type fatty acid binding protein in patients with acute coronary syndromes. Circulation 2006; 114:550–557.
  • Onda T., Inoue K., Suwa S. et al. Reevaluation of cardiac risk scores and multiple biomarkers for the prediction of first major cardiovascular events and death in the drug-eluting stent era. Int J Cardiol. 2016;219:180-5.
  • Body R., Burrows G., Carley S. et al. The Manchester Acute Coronary Syndromes (MACS) decision rule: validation with a new automated assay for heart-type fatty acid binding protein. Emerg Med J. 2015;32(10):769-74.
  • Greenslade J.H., Nayer R., Parsonage W. et al. Validating the Manchester Acute Coronary Syndromes (MACS) and Troponin-only Manchester Acute Coronary Syndromes (T-MACS) rules for the prediction of acute myocardial infarction in patients presenting to the emergency department with chest pain. Emerg Med J. 2017;34(8):517-23.
  • Jones J.D., Chew P.G., Dobson R. et al. The prognostic value of heart type fatty acid binding protein in patients with suspected acute coronary syndrome: A systematic review. Curr Cardiol Rev. 2017;13(3):189-98.
  • Hai-Long W., Xiao-Hua P., Jian-Jun Y. The prognostic value of heart-type fatty acid binding protein in patients with acute coronary syndrome. J Coll Physicians Surg Pak. 2018;28(1):56-60.


    • About the Autors

    Valentin A. Kokorin, MD, PhD, associate professor of the Hospital therapy #1 department of Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow. Е -mail: valentinkokorin@yahoo.com


    Similar Articles

    Back to Content

    Бионика Медиа