Analytical and clinical evaluation of a new heart-type fatty acid-binding protein automated assay
-
Martina Zaninotto
, Monica Maria Mion , Enrica Novello , Sara Altinier , Stefano Rocco , Luisa Cacciavillani , Martina Perazzolo Marra , Sabino Iliceto und Mario Plebani
Abstract
Background: The accurate and rapid recognition of myocardial injury in patients presenting in the emergency department (ED) with chest pain continues to be a clinical challenge. Heart-type fatty acid-binding protein (H-FABP) appears to be one of the best candidates among the new early cardiac markers studied.
Methods: We evaluated the analytical characteristics of a new quantitative and fully automated H-FABP assay (Randox Laboratories Ltd., Crumlin, UK) and compared its clinical performance with respect to the myoglobin (Myo) assay (Dade Behring, Milan, Italy). A precision study was carried out by testing three levels of quality control (QC) material and two in-house pool (P) samples. To test the accuracy of H-FABP determinations in plasma (lithium-heparin) samples, H-FABP concentrations measured in a set of matched sera and plasma samples were compared. A total of 77 non-consecutive patients (51 males and 26 females; 62±16years) who presented to the ED with chest pain suggesting myocardial ischemia were enrolled. The patients were classified into two groups (acute myocardial infarction, n=22; non-acute myocardial infarction, n=55) on the basis of the discharge diagnosis.
Results: The between-day imprecision for three levels of control material and serum pool samples was 6.26%–8.04% (range 2.32–44.03μg/L) and 9.03%–12.63% (range 11.85–65.13μg/L), respectively. In the serum vs. plasma study, bias was +0.178 (95% CI −0.033 to +0.389). The best cut-off and the associated diagnostic efficacy were 95μg/L and 89.47% for Myo and 5.09μg/L and 98.70% for H-FABP, respectively.
Conclusions: H-FABP determination in patients with ischemic symptoms may be a more reliable early indication of cardiac damage than myoglobin.
Clin Chem Lab Med 2006;44:1383–5.
References
1. Alpert JS, Thygesen K, Antman E, Bassand JP. Myocardial infarction redefined – a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. J Am Coll Cardiol 2000; 36:959–69.10.1016/S0735-1097(00)00804-4Suche in Google Scholar
2. Pope JH, Aufderheide TP, Ruthazer R, Woolard RH, Feldman JA, Beshansky JR, et al. Missed diagnoses of acute cardiac ischemia in the emergency department. N Engl J Med 2000; 342:1163–70.10.1056/NEJM200004203421603Suche in Google Scholar
3. Plebani M, Zaninotto M. Diagnostic strategies using myoglobin measurement in myocardial infarction. Clin Chim Acta 1998; 272:69–77.10.1016/S0009-8981(97)00253-2Suche in Google Scholar
4. Glatz JF, van Bilsen M, Paulussen RJ, Veerkamp J, van der Vusse GJ, Reneman RS. Release of fatty acid-binding protein from isolated rat heart subjected to ischemia and reperfusion or to the calcium paradox. Biochim Biophys Acta 1988; 961:148–52.10.1016/0005-2760(88)90141-5Suche in Google Scholar
5. Pelsers MM, Hermens WT, Glatz JF. Fatty-acid binding proteins as plasma markers of tissue injury. Clin Chim Acta 2005; 352:15–35.10.1016/j.cccn.2004.09.001Suche in Google Scholar
6. Glatz JF, van der Vusse GJ. Cellular fatty acid-binding proteins: their function and physiological significance. Prog Lipid Res 1996; 35:243–82.10.1016/S0163-7827(96)00006-9Suche in Google Scholar
7. Azzazy HM, Pelsers MM, Christenson RH. Unbound free fatty acids and heart-type fatty acid-binding protein: diagnostic assays and clinical applications. Clin Chem 2006; 52:19–29.10.1373/clinchem.2005.056143Suche in Google Scholar PubMed
8. Robers M, Van der Hulst FF, Fischer MA, Roos W, Salud CE, Eisenwiener HG, et al. Development of a rapid microparticle-enhanced turbidimetric immunoassay for plasma fatty acid-binding protein, an early marker of acute myocardial infarction. Clin Chem 1998; 44:1564–67.10.1093/clinchem/44.7.1564Suche in Google Scholar
9. Okamoto F, Sohmiya K, Ohkaru Y, Kawamura K, Asayama K, Kimura H, 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; 38:231–8.10.1515/CCLM.2000.034Suche in Google Scholar PubMed
10. Alhashemi JA. Diagnostic accuracy of a bedside qualitative immunochromatographic test for acute myocardial infarction. Am J Emerg Med 2006; 24:149–55.10.1016/j.ajem.2005.08.002Suche in Google Scholar PubMed
©2006 by Walter de Gruyter Berlin New York
Artikel in diesem Heft
- Renal function – estimation of glomerular filtration rate
- Research translation: a new frontier for clinical laboratories
- Association of APOA5 c.553G>T polymorphism with type 2 diabetes mellitus in a Chinese population
- MTRR 66A>G polymorphism in relation to congenital heart defects
- Increased homocysteine in heart failure: a result of renal impairment?
- Urine flow cytometry and detection of glomerular hematuria
- Chymotrypsin effects on the determination of sperm parameters and seminal biochemistry markers
- Evaluation of cardiac involvement following major orthopedic surgery
- Increased sensitivity in detecting renal impairments by quantitative measurement of marker protein excretion compared to detection of pathological particles in urine sediment analysis
- Clinical chemistry reference values for 75-year-old apparently healthy persons
- Serum pro-hepcidin concentrations and their responses to oral iron supplementation in healthy subjects manifest considerable inter-individual variation
- Comparability of five analytical systems for the determination of triiodothyronine, thyroxine and thyroid-stimulating hormone
- Automated analysis of pleural fluid total and differential leukocyte counts with the Sysmex XE-2100
- Automation and validation of a fast method for the assessment of in vivo oxidative stress levels
- Analytical validation of the new plasma calibrated Accu-Chek® Test Strips (Roche Diagnostics)
- Use of insulin immunoassays in clinical studies involving rapid-acting insulin analogues: Bi-insulin IRMA preliminary assessment
- Analytical and clinical evaluation of a new heart-type fatty acid-binding protein automated assay
- A caveat for OV-Monitor (CA 125 antigen) measurement: something is improving, something is not
- Reply to the letter written by Dorizzi et al.
Artikel in diesem Heft
- Renal function – estimation of glomerular filtration rate
- Research translation: a new frontier for clinical laboratories
- Association of APOA5 c.553G>T polymorphism with type 2 diabetes mellitus in a Chinese population
- MTRR 66A>G polymorphism in relation to congenital heart defects
- Increased homocysteine in heart failure: a result of renal impairment?
- Urine flow cytometry and detection of glomerular hematuria
- Chymotrypsin effects on the determination of sperm parameters and seminal biochemistry markers
- Evaluation of cardiac involvement following major orthopedic surgery
- Increased sensitivity in detecting renal impairments by quantitative measurement of marker protein excretion compared to detection of pathological particles in urine sediment analysis
- Clinical chemistry reference values for 75-year-old apparently healthy persons
- Serum pro-hepcidin concentrations and their responses to oral iron supplementation in healthy subjects manifest considerable inter-individual variation
- Comparability of five analytical systems for the determination of triiodothyronine, thyroxine and thyroid-stimulating hormone
- Automated analysis of pleural fluid total and differential leukocyte counts with the Sysmex XE-2100
- Automation and validation of a fast method for the assessment of in vivo oxidative stress levels
- Analytical validation of the new plasma calibrated Accu-Chek® Test Strips (Roche Diagnostics)
- Use of insulin immunoassays in clinical studies involving rapid-acting insulin analogues: Bi-insulin IRMA preliminary assessment
- Analytical and clinical evaluation of a new heart-type fatty acid-binding protein automated assay
- A caveat for OV-Monitor (CA 125 antigen) measurement: something is improving, something is not
- Reply to the letter written by Dorizzi et al.