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; Mario Plebani

doi:10.1515/CCLM.2006.246

Enjoy 40% off

academic books on De Gruyter Brill *

Article

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 and Mario Plebani

Published/Copyright: November 7, 2006

Published by

Become an author with De Gruyter Brill

Submit Manuscript Author Information

From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 44 Issue 11

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.

Keywords: acute coronary syndrome; acute myocardial infarction; emergency department; heart-type fatty acid-binding protein; myoglobin; protein biochip microarray

Corresponding author: Martina Zaninotto, Department of Laboratory Medicine, University Hospital of Padova, via Giustiniani 2, 35128 Padova, Italy Fax: +39-049-8218489, martina.zaninotto@sanita.padova.it

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)00804-4Search 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/NEJM200004203421603Search 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)00253-2Search 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)90141-5Search 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.2004.09.001Search 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)00006-9Search 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.2005.056143Search 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/44.7.1564Search 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.2000.034Search 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.2005.08.002Search in Google Scholar PubMed

Received: 2006-6-16

Accepted: 2006-8-2

Published Online: 2006-11-7

Published in Print: 2006-11-1

You are currently not able to access this content.

Articles in the same Issue

https://doi.org/10.1515/CCLM.2006.246

Keywords for this article

acute coronary syndrome; acute myocardial infarction; emergency department; heart-type fatty acid-binding protein; myoglobin; protein biochip microarray