Heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction: a systematic review and meta-analysis.
| Autor: | Bruins Slot MH; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, GA Utrecht, The Netherlands. m.h.e.bruinsslot@umcutrecht.nl, Reitsma JB, Rutten FH, Hoes AW, van der Heijden GJ |
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| Jazyk: | angličtina |
| Zdroj: | Heart (British Cardiac Society) [Heart] 2010 Dec; Vol. 96 (24), pp. 1957-63. |
| DOI: | 10.1136/hrt.2010.208272 |
| Abstrakt: | Objective: To determine the accuracy of heart-type fatty acid-binding protein (H-FABP) as a new and early cardiac biomarker in the early diagnosis of acute myocardial infarction (AMI). The introduction of early and safe biomarkers could lead to (a) a large reduction in unnecessary hospital referrals of patients suspected of, but not, having AMI and (b) an earlier start of treatment in patients with AMI. Design: Diagnostic meta-analysis. Setting: Hospital and pre-hospital. Patients: Consecutive patients suspected of having AMI. Main Outcome Measures: A summary estimate for sensitivity and specificity was calculated using the bivariate random-effects approach, and covariate analysis was used to examine sources of heterogeneity between studies. Results: A systematic search yielded 16 studies (3709 patients, prevalence of AMI 13-74%, male gender 49-84%, median age 64-76 years). The summary estimate was 84% (95% CI 76% to 90%) for sensitivity and 84% (95% CI 76% to 89%) for specificity. Covariate analyses revealed that the use of troponin in the reference standard for AMI (as opposed to creatine kinase or creatine kinase-myocardial band) had a significant impact on sensitivity. Conclusion: H-FABP does not fulfil the requirements needed for a safe and early diagnosis of AMI when used as a stand-alone test. Sound diagnostic studies examining the additional role of H-FABP combined with clinical findings and other diagnostic tests are needed to further clarify a potential future role for this cardiac biomarker. |
| Databáze: | MEDLINE |
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