Abstract 19853: Use of the Multi-marker Biochip, Containing H-fabp, Ctni and Ck-mb, for Early Diagnosis of Acute Myocardial Infarction.
Background: The early identification of acute myocardial infarction (AMI) remains a significant challenge in Emergency Departments (ED) worldwide, and often the management of chest pain patients represents a major logistical and financial burden. The aim of this study was to evaluate the diagnostic efficacy of a multi-marker biochip that provides simultaneous quantitative measurements of four cardiac biomarkers in a single sample and determine whether this multi-marker approach was comparative with single analyte determination in the early hours following chest pain onset.
Methods: Blood samples from 1128 patients presenting with chest pain to the hospital ED provided a total of 2,924 venous blood samples from a series of time points on admission, 2, 4, 6, 8, 10, 12, 24 and up to 48 hours. These samples were analysed using the Cardiac Array that simultaneously measures heart-type fatty acid-binding protein (H-FABP), cardiac troponin I (cTnI), creatine kinase-MB (CK-MB) and myoglobin (MYO).
Results: The multi-marker combination of H-FABP, cTnI and CK-MB on the Cardiac biochip array presented 88.2% sensitivity for AMI diagnosis at 3-6 hours post pain, in comparison to 67.6% for cTnI alone. For this time interval, the negative predictive value (NPV) for this marker combination was 98%, compared with 95% for cTnI. H-FABP was found to have the highest AUC in the ROC curves for both 0-3 hrs (0.841) and 3-6 hrs (0.894) post pain.
Conclusion: The results suggest that the multi-marker approach utilised by the cardiac biochip array has potential as a valuable diagnostic tool for the early diagnosis of AMI/ACS and also a valuable rule-out test for patients presenting at 3-6 hours post chest pain onset. This could potentially assist ED physicians in the risk stratification of suspected AMI/ACS patients during the early hours following symptom onset. Further studies will assess the diagnostic efficacy of this array when compared to the latest high sensitivity troponin assays.
- © 2010 by American Heart Association, Inc.