Abstract 4352: Comparison of Heart-type Fatty Acid Binding Protein With Cardiac Troponin I for Early Detection of Myocardial Infarction After Coronary Bypass Surgery
Objectives: Heart-type fatty acid binding protein (hFABP) has been suggested as a novel marker to detect myocardial injury shortly after onset of ischemia. We therefore compared cardiac troponin I (cTnI), which is most sensitive and specific for myocardial infarction, with hFABP in respect of fast and reliable response after coronary artery bypass grafting (CABG).
Methods: One-hundred-eight consecutive patients undergoing isolated primary CABG with cardiopulmonary bypass were enrolled in this prospective study. Serial blood samples were taken preoperatively, and at 1, 6, 12, 24, and 48 hours (h) after surgery; electrocardiograms, clinical data and events were recorded. hFABP and cTnI was analyzed using a combined quantitative bedside assay (CardioDetect® combi, Rennessens GmbH, Berlin, Germany). A postoperative myocardial infarction (PMI) was defined by new Q-waves on electrocardiogram or a cTnI elevation (>10.5 ng/ml) within the first 24h after surgery.
Results: A total of 14 out of 108 patients (group 1) were identified with PMI by using the above mentioned criteria, whereas 94 patients had no PMI and thus, were used as controls (group 2). As a result, both hFABP and cTnI were significantly increased in group 1 compared to group 2 (P<0.001; ANOVA), hFABP however separated much earlier (1h after surgery) between group 1 and 2, whereas cTnI differed not until 12h after surgery between the groups. A hFABP level of 20 μg/mL 1h after CABG best detected the presence of PMI with an area under the receiver operating characteristic (ROC) curve of 78.3% (sensitivity: 93%, specificity: 68%).
Conclusion: hFABP is a sensitive and specific biomarker, which detects PMI reliably as soon as 1h after CABG and thus much earlier than cTnI.