A study to compare Troponin and Heart-Type Fatty Acid Binding Protein as cardiac markers.
University of Wales Institute Cardiff
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Introduction:- Cardiac markers play an important role in identifying myocardial injury and also enable the practitioner to be able to categorise the patient as high, moderate or low risk for an adverse cardiac advent (1). The gold standard test for myocardial damage is Troponin. Troponin I and T are cardiac regulatory proteins that control the calcium mediated interaction between actin and myosin (2) which are released in complete myocardial damage. A new cardiac marker has been introduced called Heart Type Fatty Acid Binding Protein (H-FABP) which is a small cytosolic protein that is released rapidly from the cardiomyocyte in response to myocardial injury and can be detected as early as 2 to 3 hours after myocardial injury (3), suggesting that H-FABP is a potential new early cardiac marker for myocardial injury. The aim of this project is to test the hypothesis that Heart Type Fatty Acid Binding Protein is a more effective early cardiac marker of myocardial injury than the gold standard Troponin by investigating if the results are comparable in patients with chest pain and suspected myocardial injury. Methods:- samples were obtained from 134 patients with chest pain. Troponin is measured by the AccuTN1 assay on the Access immunoassay system. The AccuTN1assay is a paramagnetic particle, chemiluminescent immunoassay. It is a quantitative method used to measure cardiac Troponin I (cTnI) levels in human serum. H-FABP is measured on the Konelab 30 analyser. The Randox H- FABP assay is an immunoturbidimetric assay. It is a quantitative method used to measure H-FABP levels in human serum. Results:- 134 patients with chest pain using the cardiac markers Troponin and H – FABP. The Troponin assay had 19 positive results of >0.04 ng/ml and 115 negative results of <0.04 ng/ml for the detection of myocardial injury. The H-FABP assay had 40 positive results of >6.48µ/L, and 94 negative results of <6.48µ/L for the detection of myocardial injury. Conclusion:- the statistical data suggests that there is an association between a positive and negative result for myocardial injury using Troponin and H-FABP and that the Troponin assay is giving a lower number of positive results than H-FABP assay. The data supplied by this study and considering the previous research and litriature that suggests that a combination cardiac biomarker approach is the most effective method to diagnose patients with myocardial injury.
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