Details

Autor(en) / Beteiligte

• McCann, Conor J.
• Glover, Ben M.
• Menown, Ian B.A.
• Moore, Michael J.
• McEneny, Jane
• Owens, Colum G.
• Smith, Bernie
• Sharpe, Peter C.
• Young, Ian S.
• Adgey, Jennifer A.

Titel

Novel biomarkers in early diagnosis of acute myocardial infarction compared with cardiac troponin T

Ist Teil von

• European heart journal, 2008-12, Vol.29 (23), p.2843-2850

Ort / Verlag

England: Oxford University Press

Erscheinungsjahr

2008

Link zum Volltext

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• 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 ≥12 h cTnT sample was also obtained. MI was defined as cTnT ≥ 0.03 µg/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 ≤ 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.