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Articles |
1
Department of Internal Medicine, Fujita Health University School of Medicine, 1–98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470–11, Japan.
2
Department of Clinical Chemistry, Fujita Health
University School of Health Sciences, Toyoake, Aichi, Japan
3
Third Division, Department of Internal Medicine, Osaka
Medical College, Takatsuki, Japan.
a Author for correspondence. Fax 81 562 93 2315; e-mail tkondo{at}fujita-hu.ac.jp
We compared the diagnostic utility of serum concentrations of human
heart-type cytoplasmic fatty acid-binding protein (H-FABPc), myoglobin,
and their ratio for the early diagnosis of acute myocardial infarction
(AMI) in 104 healthy volunteers and 165 patients at admission within
6 h of the onset of chest pain. The ROC curves of the H-FABPc
[0.946, 95% confidence interval (CI) = 0.913–0.979] and myoglobin
(0.895, 95% CI = 0.846–0.944) between patients with AMI and
healthy volunteers were significantly greater than the area under the
ratio of myoglobin to H-FABPc (0.823, 95% CI = 0.765–0.881). In
165 patients, the sensitivity (81.8%, 95% CI = 74.2–89.4%),
specificity (86.4%, 95% CI = 78.1–94.6%), and predictive
accuracy (83.6%, 95% CI = 78.0–89.3%) of H-FABPc >12 µg/L
in diagnosing AMI were significantly higher than those of myoglobin,
and were similar to those of the combination of H-FABPc >12 µg/L and
the ratio 
14. We conclude that H-FABPc is a more sensitive and
specific marker than myoglobin for the early diagnosis of AMI,
and that their ratio cannot give a clear advantage over the measurement
of H-FABPc alone.
Key Words: indexing terms: biochemical markers • myocardial injury
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