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The assessment of chest pain patients presenting to the emergency area (EA) is still a clinical challenge, as the majority of patients are not diagnosed with acute coronary syndrome (ACS). New generation high sensitivity c-Tn (hs-cTn) assays have showed better performances compared to the standard c-Tn. However, hs-Tn still presents some limitations. Hence, novel, early biomarkers are needed in this setting. Among all, heart-type fatty acid binding protein (H-FABP) has been largely investigated. This article reviews the studies evaluating H-FABP performance in diagnosing acute myocardial infarction (AMI) and stratifying chest pain patients by risk. H-FABP optimal performances in ACS have been reported by studies that used low threshold for positivity, or compared the biomarker to cTn at 3-6 h, or by studies with small sample size. Literature review allows stating that H-FABP is clearly not a reliable marker in ACS, as it is unable to diagnose AMI, neither as a stand-alone test nor combined with hs-cTn. Few evidence supports its incremental value in ruling-out AMI and its risk stratification ability for chest pain patients presenting to EA. Thus, available data may not encourage going on investigating., (Copyright © 2018. Published by Elsevier Inc.)

Objectives: Glycated Albumin (GA) has been proposed as a screening marker for diabetes in Asian countries in the last years. Nevertheless, few studies have been conducted in Caucasian population. The aim of this study is to evaluate the clinical usefulness of GA in diabetes diagnosis in Caucasian asymptomatic subjects considered at risk of diabetes based on medical history and Fasting Plasma Glucose (FPG)., Design and Methods: Three hundred and thirty-four Caucasian subjects having one or more risk factor for diabetes, and/or FPG ranging from 5.6 mmol/L to 6.9 mmol/L with no symptoms for diabetes were enrolled in this study. Plasma GA was measured by an enzymatic method (quantILab Glycated Albumin) on ILab Taurus instrument (Instrumentation Laboratory - A Werfen Company)., Results: GA median levels were 13.2% (IQR:12.2-14.4). Eighteen subjects (5.4%) were classified as diabetics based on their HbA1c. According to the ROC curve analysis, GA identified subjects with diabetes with a sensitivity of 72.2% (95% CI: 46.5-90.3) and a specificity of 71.8% (95% CI: 66.5-76.7) (AUC: 0.80; 95% CI: 0.75-0.84; P < 0.0001) at the cut-off of 14%. The cut-off of 13.5% was associated to a higher sensitivity 88.9% (95%CI: 65.3-98.6) and a specificity of 60.4% (95%CI, 54.8-65.9)., Conclusions: This study confirms the clinical usefulness of GA for the diagnosis of diabetes in Caucasian subjects at risk for diabetes. More studies are required to clarify the role of GA in relation to the other diagnostic criteria for diabetes., (Copyright © 2018. Published by Elsevier Inc.)

Acute coronary syndrome (ACS) is a very common cause of hospitalizations worldwide each year. In the past decades biomarkers have become an indispensable tool for diagnosis, risk stratification and prognosis of cardiovascular disease, including ACS. Despite Troponin is considered the gold standard in diagnosis of ACS, several molecules have been investigated to identify predictive biomarkers of prognosis. Among these, Gal-3 has emerged as a promising prognostic marker. It has a pivotal role in inflammation and fibrosis. Both experimental and clinical studies have shown Gal-3 is an independent predictor of all-cause mortality, cardiovascular death and occurrence of HF following ACS. This article reviews the literature data regarding the role of Galectin-3 in ACS setting., (Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.)

Objectives: Although the importance of serum Procalcitonin (PCT) levels at diagnosis is well established in adult Community-Acquired Pneumonia (CAP), its use remains controversial in pediatric CAP. The aim of our study is to investigate the role of PCT and C-Reactive Protein (CRP) in the assessment of pediatric CAP severity defined by the extent of consolidation on chest X-rays and the presence of pleural effusion. In this particular setting, no clinical severity score is available at present and chest X-ray, although important for diagnosis confirmation, is not recommended as routine test., Design and Methods: The study involved 119 children admitted to the Department of Pediatric Infectious Disease for radiographically documented CAP aged 1 year to 14 years, without chronic diseases. Baseline PCT, CRP and routine laboratory tests were performed on admission., Results: The median PCT (μg/L) and CRP (mg/L) were 0.11 (0.05–0.58) and 21.3 (4.2–48.1), respectively. PCT showed a good correlation with CRP, neutrophils and WBC (r = 0.538, P < 0.001; r = 0.377, P < 0.001; r = 0.285, P0.002, respectively). CRP, but not PCT, was associated with lobar consolidation (P = 0.007) and pleural effusion (P = 0.002). Logistic regression analysis revealed that only CRP was a predictor of lobar consolidation (OR: 1.078; 95% CI: 1.017–1.143; P = 0.011) and pleural effusion (OR: 1.076; 95% CI: 1.005–1.153; P = 0.036)., Conclusion: Our findings revealed that PCT is correlated to the main inflammatory markers in children with CAP. CRP, unlike PCT, is able to predict the extent of chest X-ray infiltration and ultimately the severity of the disease confirming its usefulness in the management of pneumonia

Objectives: Serum Fetuin A has been identified as an inhibitor of ectopic calcification. It is reduced in subjects with chronic kidney disease (CKD) and it has been proposed as a potential link between CKD and the higher prevalence of arterial calcification observed in these patients. During aging both the stiffening of arterial wall due to calcification and a decline in kidney function are frequent. The aim of the study is to investigate if Fetuin A serum levels are associated with aging and with AHSG T256S polymorphism. Moreover, we aim at investigate whether serum Fetuin A is correlated to kidney function in this setting of senescence., Design and Methods: 256 health long-lived subjects (age 92 [81-100]) were recruited for the study. Serum Fetuin A was evaluated by ELISA, Cystatin C by immune-nephelometry. AHSG T256S was determinated by PCR-RFLP., Results: Serum Fetuin A shows a significant correlation with age (r=0.20; P=0.0048). AHSG TS and SS genotypes are associated to lower levels of serum protein (0.27 [0.19-0.29] g/L vs 0.42 [0.32-0.49] g/L; P<0.027 and 0.34 [0.25-0.41] g/L vs 0.42 [0.32-0.49] g/L; P<0.001, respectively). No significant correlation between Fetuin A and Cystatin C was observed., Conclusions: Serum Fetuin A increases with age in elder individuals and subjects with the TS or SS AHSG polymorphism have lower levels of the circulating protein. No correlation with kidney function decline was observed. Other mechanisms should be investigated to explain the increase of Fetuin A with age., (Copyright © 2012 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.)