Role Of Novel Biomarker Heart Type Fatty Acid Binding Protein In Diagnosing Acute Coronary Syndrome In Comparison With Troponin I And Ck-Mb – A One Year Cross Sectional Study In Kles Dr Prabhakar Kore Hospital And Mrc, Belgaum

Abstract

Background and objectives Recent studies suggest that human heart type fatty acid binding protein (H-FABP) may be a potential marker for early diagnosis of ACS. This study was aimed to assess the utility of H-FABP as an early biomarker in patients with acute coronary syndrome in comparison with troponin I. Methodology The present one year cross-sectional study was done in the Department of Medicine, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum from January 2013 to December 2013. A total of 61 patients who presented with acute coronary syndrome were studied. Estimation of H-FABP was done using H-FABP, Human, ELISA kit. Results Males constituted 68.85% of the study population and 31.15% were females. The commonest age group was between 61 to 70 year (34.43%) and the mean age was noted as 59.75 ± 11.34 years. Majority of the patients (98.36%) presented with chest pain. History of hypertension and diabetes was present in 47.5% and 36.07% of the patients respectively. Personal history of alcohol consumption and smoking was noted in 26.23% of the patients each and tobacco chewing was noted in 22.95%. On examination, 21.31% of the patients presented with pallor. On ECG, the commonest diagnosis was ASMI (36.07%) followed by IWMI (26.23%). Majority (90.16%) of the patients had raised troponin I (>0.04) levels and H-FABP was raised in 98.36% of the patients. Of the 57 patients with raised H-FABP levels, 54 had raised troponin I levels and 3 had normal troponin I yielding to a sensitivity of 98.18% and specificity of 50%. The strength of agreement in predicting the diagnosis of ACS was 'moderate (Kappa=0.566; SE of kappa = 0.193; 95% CI: From 0.187 to 0.944). The sensitivity and specificity of H-FABP considering CK-MB as reference standard was 92.59% and 25% respectively. Conclusion and interpretation Raised serum H-FABP, plays an important role in the early diagnosis of acute coronary syndromes.