Comparative study of high sensitivity troponin T and heart-type fatty acid-binding protein in STEMI patients

الملخص EN

Aim and background : Heart-type fatty acid-binding proteins (H-FABP) which are detected within 2-3 h of acute myocardial infarction are involved in uptake of free fatty acids in the myocardium.

Our aim in the present study is to compare window periods of H-FABP to high sensitivity troponin T (hs-Trop T) in acute ST elevation myocardial infarction (STEMI).

Methods : 160 STEMI diagnosed patient’s serum samples are analyzed for hs-Trop T and H-FABP.

Different window periods of chest pain onset (< 3 h, 3-6 h and > 6 h) are compared with complications, in-hospital mortality and statistically analyzed.

Results : From 160 patients, 53 (33 %) cases are presented in < 3 h, 75 (47 %) in 3-6, and 32 (20 %) after > 6 h respectively.

Accordingly sensitivity of hs-Trop T was 92 %, 94 % and 97 % while H-FABP was 75 %, 88 % and 84 %, respectively.

Overall sensitivity was 94 % and 82 % respectively.

Statistically significant difference between mean hs-Trop T values with respect to window period < 3, 3-6 and > 6 h was 0.21, 0.35 and 0.80 ng / ml respectively, p value < 0.0001.

No significant difference in H-FABP values was observed.

Hs-Trop T positively correlated with age (r = 0.153, P = 0.05), window period (r = 0.363, P < 0.0001), TIMI score (r = 0.208, P = 0.008), ejection fraction (r = 0.191, P = 0.008), serum H-FABP (r = 0.229, P = 0.004), and serum hs-CRP (r = 0.326, p < 0.001).

There was a statistically significant difference of mean hs-Trop T values with or without in hospital mortality (0.35 vs.

0.85 ng / ml, respectively, p = 0.008).

No significant correlation to age, TIMI score, ejection fraction and hs-CRP values for H-FABP was observed.

Conclusion : It appears that hs-Trop T is a more sensitive marker than H-FABP in early hours of AMI and higher hs-Trop T predicts increase in-hospital mortality.