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

The European Journal of General Practice
Robert T A WillemsenGeert Jan Dinant

Abstract

Most patients presenting chest complaints in primary care are referred to secondary care facilities, whereas only a few are diagnosed with acute coronary syndrome (ACS). The aim is to determine the optimal cut-off value for a point-of-care heart-type fatty acid binding protein (H-FABP) test in patients presenting to the emergency department and to evaluate a possible future role of H-FABP in safely ruling out ACS in primary care. Serial plasma H-FABP (index test) and high sensitivity troponin T (hs-cTnT) (reference test) were determined in patients with any new-onset chest complaint. In a receiver operating characteristic (ROC) curve, the optimal cut-off value of H-FABP for ACS was determined. Predictive values of H-FABP for ACS were calculated. For 202 consecutive patients (prevalence ACS 59%), the ROC curve based on the results of the first H-FABP was equal to the ROC curve of hs-cTnT (AUC 0.79 versus 0.80). Using a cut-off value of 4.0 ng/ml for H-FABP, sensitivity for ACS of the H-FABP (hs-cTnT) tests was 73.9% (70.6%). Negative predictive value (NPV) of H-FABP for ACS in a population representative for primary care (incidence of ACS 22%) thus could reach 90.8%. In patients presenting chest pain, plasma H-FABP reaches the h...Continue Reading

References

May 15, 1998·Clinica Chimica Acta; International Journal of Clinical Chemistry·J F GlatzW T Hermens
Aug 30, 2000·International Journal of Cardiology·F H RuttenA W Hoes
Feb 6, 2004·Annals of Internal Medicine·Penny WhitingJos Kleijnen
Mar 10, 2007·QJM : Monthly Journal of the Association of Physicians·P MadH Herkner
Mar 1, 2008·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Rudi BruyninckxFrank Buntinx
Dec 29, 2009·Resuscitation·Richard BodyKevin Mackway-Jones
Jan 7, 2011·The American Journal of Emergency Medicine·C Geraldine McMahonS Peter Fitzgerald
Aug 28, 2012·European Heart Journal·UNKNOWN Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC)Doron Zahger
Aug 28, 2012·Circulation·Kristian ThygesenShanti Mendis
Feb 1, 2013·International Journal of Family Medicine·Staffan NilssonJan-Erik Karlsson
Dec 21, 2013·European Heart Journal·Christian Mueller

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Citations

Oct 28, 2015·BioMed Research International·Radmilo JankovićVesna Dinić
Jul 19, 2016·Chemical Reviews·Mahmoud LabibShana O Kelley
Dec 19, 2017·Primary Health Care Research & Development·Robert T A WillemsenUNKNOWN ‘RAPIDA’ – Study Team (‘RAPIDA’: RAPid Test for Investigating Complaints Possibly Due to Acute Coronary Syndrome)

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