Prognostic Value of Heart-Type Fatty Acid Binding Protein in Patients with Acute Coronary Syndrome, MOHAMED HASAN, NOURA ISMAIL, AMAL REZK, EMAD OMAR and AMR EL-HADIDY
Abstract
Background: Heart-type fatty acid-binding protein is released into the circulation following myocardial ischemia and necrosis and therefore may be add a prognostic value when caring for patients admitted to hospital with a clinical diagnosis of ACS.
Objective: To establish the prognostic value of rapid Heart-type Fatty Acid-Binding Protein (H-FABP) test in patients with Acute Coronary Syndrome (ACS).
Patients and Methods: Ninety patients admitted to Critical Care Department with acute coronary syndrome (within 24 h duration), irrespective of (ECG) changes, were subjected to detailed and full history taking and thorough clinical examination, 12 lead ECG, an echocardiography, full laboratory investigation, including cardiac enzymes, troponin, and H-FABP, coronary angiography to assess the severity of coronary artery disease using modified Ginssini score, and follow-up for the incidence of cardiac events either during hospitalization, or during six-months follow-up.
Results: Mean patient age was 56 years (SD 12), 88% was male, H-FABP test was performed within 24h after symptom onset, and was elevated in 80% of the patients. The value of H-FABP correlated with the severity of coronary artery lesion as determined by modified ginsini score (r=0.749, p<0.001), and with long hospital stay (p<0.001). Increasing H-FABP concentration remained statistically significant as Independent predictors of long-term risk (namely; heart failure with 75% and 92% sensitivity and specificity respectively at H-FABP 43.95ng/ml, and recurrent ischemia with 71% and 96% sensitivity and specificity respectively at H-FABP 44.50 ng/ml) during six-months follow-up.
Conclusion: Increasing H-FABP value has a prognostic role in prediction of incidence of heart failure and ischemic heart disease during six-month follow-up, irrespective of troponin level.