Role of Serum Fatty Acid Binding Protein and High Sensitive Cardiac Troponin in Diagnosis and Differentiation of Acute Coronary Syndrome

Abstract

ABSTRACT
Background  Acute  coronary  syndrome  (ACS)  refers  to  any  group  of  clinical symptoms compatible with acute myocardial ischemia including unstable angina, Non-ST-segment  elevation  myocardial  infarction  &  ST-segment  elevation myocardial infarction. Heart - type  fatty acid  binding  protein  ( H-FABP )  also  known    as  mammary-derived  growth  inhibitor  is  a  protein  that  in  humans  is encoded by the FABP3 gene, The diagnostic potential of the biomarker H-FABP for heart injury. The aim was to To evaluate serum levels of FABP in patients with Acute  Coronary  Syndrome  subgroups  and  investigate  its  role  in  differentiation among them.
Patients  &  Methods: The  present  study  was  conducted  at  the  Department  of Biochemistry, College of Medicine/ University of Baghdad during the period from December 2017 until August 2018. Thirty three patients with ACS were included as 11 with unstable angina (UA), 11 with non ST elevation myocardial infarction  (NSTEMI),  & 11 ST elevation myocardial infarction (STEMI) patients. Also this study included 18 non-ischemic chest pain subjects who served as pathological control. Blood samples were obtained for measurements of FABP and hs-cTn by ELISA method.
The  Results: The  mean  (±SD)  value  of  FABP  was  significantly  increased  in NSTEMI (3.80‎ ±‎ 1.45ng/ml, p< 0.001) and UA (3.62‎ ±‎ 0.42 ng/ml, p < 0.001) compared to that of STEMI (1.88‎ ±‎ 1.60 ng/ml). Also, the mean value of serum H- FABP levels of pathological controls (3.17‎ ±‎ 0.73 ng/ml) was significantly higher than  that  of  STEMI  group  (p  <  0.001).  Regarding  hs-cTn,  it  did  not  differ significantly among the groups of UA (2.82‎ ±‎ 0.69), NSTMI (4.08‎ ±‎ 2.35), and STMI (4.53‎±‎2.06(
Conclusion:
FABP showed significant elevation in UA and NSTMI and  may be used as a biochemical marker in assessment of these two conditions and to differentiate them from STEMI. It used in ACS differentiation is superior of that of Tn.