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The research aimed to evaluate the association between heart-type fatty acid binding protein (H-FABP) and cardiovascular events. We systematically reviewed research that has been conducted to assess this relationship, aiming to determine how useful H-FABP could be as a biomarker for cardiovascular diseases, especially in the initial phases of acute myocardial infarction (AMI) and acute coronary syndrome (ACS). Our goal was to validate its diagnostic accuracy and clinical relevance. We systematically searched through PubMed, Web of Science, and Google Scholar databases to find pertinent publications related to cardiovascular diseases and H-FABP, using various permutations, abbreviations, and language variations of MeSH keywords. The final analysis included 12 studies in total. The final study comprised twelve studies, and it was concluded that H-FABP demonstrated high sensitivity (64.3-91.5) and specificity (73-100) for diagnosing Acute Myocardial Infarction (AMI) and Acute Coronary Syndrome (ACS), especially within the first hours of symptom onset. H-FABP demonstrates potential in enhancing the overall diagnostic accuracy during the initial hours following the manifestation of symptoms. However, the existing data do not provide sufficient evidence to recommend the regular utilization of H-FABP as a preliminary risk assessment approach in individuals who present with suspected cardiac events. Additional investigations, with well-defined prospective cohorts, are needed to validate the results observed. [ABSTRACT FROM AUTHOR]

Heart-type fatty-acid binding protein (FABP3) is an essential cytosolic lipid transport protein found in cardiomyocytes. FABP3 binds fatty acids (FAs) reversibly and with high affinity. Acylcarnitines (ACs) are an esterified form of FAs that play an important role in cellular energy metabolism. However, an increased concentration of ACs can exert detrimental effects on cardiac mitochondria and lead to severe cardiac damage. In the present study, we evaluated the ability of FABP3 to bind long-chain ACs (LCACs) and protect cells from their harmful effects. We characterized the novel binding mechanism between FABP3 and LCACs by a cytotoxicity assay, nuclear magnetic resonance, and isothermal titration calorimetry. Our data demonstrate that FABP3 is capable of binding both FAs and LCACs as well as decreasing the cytotoxicity of LCACs. Our findings reveal that LCACs and FAs compete for the binding site of FABP3. Thus, the protective mechanism of FABP3 is found to be concentration dependent. [ABSTRACT FROM AUTHOR]

Lanju Wang,1,2,* Mengli Wu,2,* Jingjing Ma,2,* Ziwei Ma,2 Jiahui Liang,2 Ningya Tao,2,3 Yangguang Ren,4 Shujun Shao,1 Xin Qi,1 Zhizeng Wang2 1Department of Blood Transfusion, the Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, Henan, 450008, People’s Republic of China; 2Joint National Laboratory for Antibody Drug Engineering, Clinical Laboratory of the First Affiliated Hospital, School of Medicine, Henan University, Kaifeng, Henan, 475004, People’s Republic of China; 3Pingyu Health School, Zhumadian, Henan, 463400, People’s Republic of China; 4Breast and Thyroid Surgery, Huaihe Hospital of Henan University, Kaifeng, Henan, 475004, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xin Qi, Department of Blood Transfusion, the Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, 450008, People’s Republic of China, Tel +86 15038239612, Email zlyyqixin4215@zzu.edu.cn Zhizeng Wang, Joint National Laboratory for Antibody Drug Engineering, Clinical Laboratory of the First Affiliated Hospital, School of Medicine, Henan University, Kaifeng, Henan, 475004, People’s Republic of China, Tel +86 15093628687, Email wzhzeng@126.comPurpose: A rapid, convenient, cost-effective in-home test method for identifying heart-type fatty acid-binding protein (H-FABP) in plasma and blood by a lateral-flow immunoassay (LFIA) based on selenium nanoparticles (SeNPs) was developed.Methods: SeNPs were synthesized by using L-ascorbic acid to reduce seleninic acid at room temperature and conjugated with an anti-H-FABP monoclonal antibody. The limit of detection, specificity, and stability were measured, and clinical samples were analyzed.Results: The SeNPs were spherical with a diameter of 39.48 ± 3.72 nm and were conjugated successfully with an anti-H-FABP antibody, resulting in a total diameter of 46.52 ± 2.95 nm. The kit was designed for the determination of H-FABP in plasma specimens and whole blood specimens. The limit of detection was 1 ng/mL in plasma and blood, and the results could be determined within 10 min. No cross-reaction occurred with cardiac troponin I, creatine kinase-MB or myoglobin. The kits were stored at 40 °C for up to 30 days without significant loss of activity. The sensitivity was determined to be 100%, the specificity 96.67%, and the overall coincidence rate 97.83%.Conclusion: This SeNP assay kit can conveniently, rapidly, and sensitively detect H-FABP in plasma or blood with a readout of a simple color change visible to the naked eye with no special device, and can be used as an auxiliary means for the early screening of AMI.Clinical Trial Registration: Plasma and blood samples were used under approval from the Experimental Animal Ethics committee of the Joint National Laboratory for Antibody Drug Engineering, Henan University. The clinical trial registration number was HUSOM-2019-047.Keywords: heart-type fatty acid-binding protein, selenium nanoparticle, lateral-flow immunoassay, point-of-care test, blood

Early and rapid diagnostic of acute myocardial infarction (AMI) during its developing stage is crucial due to its high fatality rate. Heart-type fatty acid binding protein (h-FABP) is an ideal biomarker for the quantitative diagnosis of AMI, surpassing traditional markers such as myoglobin, creatine phosphokinase-MB, and troponin in terms of sensitivity, specificity, and prognostic value. To obtain diagnostic and prognostic information, a precise and fully quantitative measurement of h-FABP is essential, typically achieved through an immunosorbent assay like the enzyme-linked immunosorbent assay. Nevertheless, this method has several limitations, including extended detection time, complex assay procedures, the necessity for skilled technicians, and challenges in implementing automated detection. This research introduces a novel biosensor, utilizing aggregation-induced emission nanoparticles (AIENPs) and integrated with a digital microfluidic (DMF) workstation, designed for the sensitive, rapid, and automated detection of h-FABP in low-volume serum samples. AIENPs and magnetic beads in nanoscale were served as the capture particles and the fluorescent probe, which were linked covalently to anti-h-FABP antibodies respectively. The approach was based on a sandwich immunoassay and performed on a fully automated DMF workstation with assay time by 15 min. We demonstrated the determination of h-FABP in serum samples with detection limit of 0.14 ng/mL using this biosensor under optimal condition. Furthermore, excellent correlations (R 2 = 0.9536, n = 50) were obtained between utilizing this biosensor and commercialized ELISA kits in clinical serum detecting. These results demonstrate that our flexible and reliable biosensor is suitable for direct integration into clinical diagnostics, and it is expected to be promising diagnostic tool for early detection and screening tests as well as prognosis evaluation for AMI patients. • New AIENPs-based biosensor had been developed for detection of h-FABP. • A droplet-extraction chip-to-world digital microfluidic workstation had been employed for this biosensor. • Demonstrated ultra-sensitive detection performance and verified by clinical samples. • AIENPs-based DMF biosensor featured a simplified operation flow and reduced turnaround time. [ABSTRACT FROM AUTHOR]

Background: Heart-type fatty acid-binding protein (H-FABP) is a new biochemical marker which is recently being used in the early diagnosis of acute coronary syndrome (ACS) in the early phase at 0-3 hours of chest pain onset. The aim of this study was to diagnose ACS patients early in the ER using H-FABP in the early stage during 0-3 hours of chest pain. Methods: This is a cross-sectional descriptive study that included 41 ACS patients who presented to the emergency department of the Suez Canal University Hospital, who fulfilled the inclusion and exclusion criteria. Results: Out of the 41 patients of ACS, 26 were male and 15 were female with a mean age of 56.8 ± 12.9 years. It was found that H-FABP was elevated in 68.3% of the patients at 0-3 hours of chest pain which increased to 80.5% at 3-6 hours of chest pain onset with 76.2% sensitivity at 0-3 hours which increased to 85.7% at 3-6 hours, while specificity was 70% at 0-3 hours but increased at 3-6 hours. The receiver operating characteristic curve was performed to find out the best cut-off value of H-FABP at 0-3 hours and at 3-6 hours' interval which was 19 ng/l for diagnosis of acute MI (ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction). Conclusion: H-FABP is a promising cardiac biomarker for the early identification of myocardial ischemia and infarction. It could be a superior biomarker for earlier detection of ACS. [SJEMed 2021; 2(2.000): 160-165]

Objective: To study the prognostic value of neutrophil/lymphocyte ratio（NLR） combined with heart-type fatty acid-binding protein（H-FABP） for prognosis of patients undergoing Stanford Type B thoracic endovascular aneurysm repair（TEVAR）.Methods: The clinical data of 172 patients with Stanford type B aortic dissection who received TEVAR in our hospital from June 2017 to September 2020 were analyzed retrospectively. Baseline data, NLR and H-FABP levels at admission and related laboratory indicators were collected. Patients’ prognosis was followed up. According to the difference in prognosis, patients were divided into poor prognosis group and good prognosis group. The above data and indicators were compared between the two groups, and the influencing factors of prognosis were analyzed by multivariate Logistic regression. Receiver operating characteristic（ROC） curve was used to analyze the prognostic value of NLR combined with H-FABP. Results: Systolic blood pressure and diastolic blood pressure in the poor prognosis group were higher than those in the good prognosis group（P<0.05）. The NLR, H-FABP and white blood cell count（WBC） levels in the poor prognosis group were higher than those in the good prognosis group, while the platelet count（PLT） level was lower than that in the good prognosis group（P<0.05）. Multivariate Logistic regression analysis showed that systolic blood pressure, diastolic blood pressure,NLR, H-FABP and WBC levels were all influencing factors for poor prognosis after TEVAR in Stanford type B aortic dissection patients（P <0.05）. ROC curve analysis showed that the area under curve of NLR combined with H-FABP in predicting the postoperative prognosis of TEVAR in Stanford type B aortic dissection patients were 0.876 which higher than those predicted by the above two indexes alone 0.626 and 0.712, respectively. Conclusion: NLR combined with H-FABP has a high prognostic value for TEVAR in Stanford type B aortic dissection patients. [ABSTRACT FROM AUTHOR]

Heart-type fatty-acid binding protein (FABP3) is an essential cytosolic lipid transport protein found in cardiomyocytes. FABP3 binds fatty acids (FAs) reversibly and with high affinity. Acylcarnitines (ACs) are an esterified form of FAs that play an important role in cellular energy metabolism. However, an increased concentration of ACs can exert detrimental effects on cardiac mitochondria and lead to severe cardiac damage. In the present study, we evaluated the ability of FABP3 to bind long-chain ACs (LCACs) and protect cells from their harmful effects. We characterized the novel binding mechanism between FABP3 and LCACs by a cytotoxicity assay, nuclear magnetic resonance, and isothermal titration calorimetry. Our data demonstrate that FABP3 is capable of binding both FAs and LCACs as well as decreasing the cytotoxicity of LCACs. Our findings reveal that LCACs and FAs compete for the binding site of FABP3. Thus, the protective mechanism of FABP3 is found to be concentration dependent.

Some studies have found that heart-type fatty acid-binding protein (H-FABP) is related to the prognosis of patients with sepsis. This study aimed to explore whether H-FABP could predict the 28-day mortality in patients with sepsis. Seven databases were searched, and the studies were screened based on the inclusion and exclusion criteria to assess the quality. The pooled sensitivity (SEN), specificity (SPE) positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and the area under the curve (AUC) of the summary receiver operating characteristic (SROC) curve were calculated along with the 95% confidence interval (CI) values. Deeks' funnel plot was used to ascertain any publication bias. Meta-regression analysis was performed to explore the possible sources of heterogeneity. Seven studies were assessed that included 822 patients with sepsis. The pooled SEN was 0.76 (95% CI, 0.71–0.81), SPE was 0.66 (95% CI, 0.61–0.70), PLR was 2.21 (95% CI, 1.73–2.83), NLR was 0.36 (95% CI, 0.29–0.54), DOR was 6.23 (95% CI, 4.27–9.11) and the pooled AUC was 0.8137. There was no publication bias. Race, literature language, sampling time, threshold division and threshold effect were not the causes for the large heterogeneity. This meta-analysis suggests that H-FABP has high accuracy in predicting the 28-day mortality rate of patients with sepsis. [ABSTRACT FROM AUTHOR]

Abstract Background Heart-type fatty acid-binding protein (H-FABP) is a novel marker of myocardial injury and has been reported to be associated with cardiovascular diseases (CVD) including patients with diabetes mellitus (DM). Unfortunately, its prognostic value in patients with CVD and impaired glucose metabolism (IGM) is unclear. The objective of this study was to investigate the prognostic value of H-FABP in CVD patients with IGM. Methods A total of 4594 patients with angiography-proven coronary artery disease (CAD) were enrolled and divided into subgroup according to glucose metabolism status (normal glucose regulation [NGR], pre-DM, and DM). Baseline levels of H-FABP were measured using latex immunoturbidimetric method. The cardiovascular events (CVE) were defined as cardiovascular death, myocardial infarction, stroke and coronary revascularization. Cox regression and Kaplan–Meier analysis were used to evaluate the relations of H-FABP and glucose metabolism status to CVEs. Results During the follow-up period with up to 7.1 years, 380 CVEs occurred. Patients with CVE had higher levels of H-FABP compared to those without CVE (p

Cardiovascular diseases (CVD) is the world’s greatest cause of mortality and are predicted to account for >23.6 million deaths by 2030. Deaths due to IHD rose by an estimated 41.7% from 1990 to 2013. In 2011, data from the World Economic Forum showed that CVD accounted for 50 percent of non-communicable disease deaths. In 2013, 70 percent of CVD deaths occurred in low and middle-income communities. CVD is a significant cause of death for both males and females globally. Early diagnosis in the emergency department may save lives in addition, it may decrease time, cost and effort for rolling in or out of patients with chest pain. This study aims to compare between Heart-type fatty acid-binding protein (H-fabp) and troponin (cTnt) point of care test for early roll outpatients with gest pain. In addition, to the early diagnosis of ST-segment elevated myocardial infarction (STEMI). A comparative prospective study was conducted in the Emergency Room (ER) at Al- Yarmouk Teaching Hospital, Baghdad, Iraq for the period extended from January 2020 to May 2020. All subjects were enlightened about the study and informed consent for participation in the study was provided. In this study 76 patients were included (36 men and 40 women) aged 37 years or older, suffering from chest pain. A 12 leads ECG and the H-FABP/cTnI Compo Rapid Test were performed for all 76 patients. Upon the findings of ECG changes, the patients were divided into 2 groups 26 patients with STEMI and 50 with normal ECG changes considered as a control group. The H-FABP/cTnI were significant in the STEMI group with higher sensitivity and specificity for troponin than H– fabp. Implementation of qualitative TnT and H-FABP testing by paramedics is feasible with a high success rate. Furthermore, for better diagnosis of ACS before hospital arrival if more sensitive point-ofcare tests are introduced ýin the prehospital phase. H-FABP and troponin can be useful for early diagnosis, particularly within the first 2 hours of symptoms, in patients attending the ýemergency department. ECG changes remain the cornerstone to diagnose STEMI. [ABSTRACT FROM AUTHOR]

Background: Early and accurate diagnosis of acute coronary syndrome (ACS) is essential for initiating lifesaving interventions. In this article, the diagnostic performance of a novel point-of-care rapid assay (SensAheart©) is analyzed. This assay qualitatively determines the presence of 2 cardiac biomarkers troponin I and heart-type fatty acid-binding protein that are present soon after onset of myocardial injury. Methods: We conducted a prospective observational study of consecutive patients who presented to the emergency department with typical chest pain. Simultaneous high-sensitive cardiac troponin T (hs-cTnT) and SensAheart testing was performed upon hospital admission. Diagnostic accuracy was computed using SensAheart or hs-cTnT levels versus the final diagnosis defined as positive/negative. Results: Of 225 patients analyzed, a final diagnosis of ACS was established in 138 patients, 87 individuals diagnosed with nonischemic chest pain. In the overall population, as compared to hs-cTnT, the sensitivity of the initial SensAheart assay was significantly higher (80.4 vs. 63.8%, p = 0.002) whereas specificity was lower (78.6 vs. 95.4%, p = 0.036). The overall diagnostic accuracy of SensAheart assay was similar to the hs-cTnT (82.7% compared to 76.0%, p = 0.08). Conclusions: Upon first medical contact, the novel point-of-care rapid SensAheart assay shows a diagnostic performance similar to hs-cTnT. The combination of 2 cardiac biomarkers in the same kit allows for very early detection of myocardial damage. The SensAheart assay is a reliable and practical tool for ruling-in the diagnosis of ACS. [ABSTRACT FROM AUTHOR]

Cardiac troponins (cTn) are currently the standard of care for the diagnosis of acute coronary syndromes (ACS) in patients presenting to the emergency department (ED) with chest pain (CP). However, their plasma kinetics necessitate a prolonged ED stay or overnight hospital admission, especially in those presenting early after CP onset. Moreover, ruling out ACS in low-risk patients requires prolonged ED observation or overnight hospital admission to allow serial measurements of c-Tn, adding cost. Heart-type fatty acid-binding protein (H-FABP) is a novel marker of myocardial injury with putative advantages over cTn. Being present in abundance in the myocellular cytoplasm, it is released rapidly (<1 h) after the onset of myocardial injury and could potentially play an important role in both earlier diagnosis of high-risk patients presenting early after CP onset, as well as in risk-stratifying low-risk patients rapidly. Like cTn, H-FABP also has a potential role as a prognostic marker in other conditions where the myocardial injury occurs, such as acute congestive heart failure (CHF) and acute pulmonary embolism (PE). This review provides an overview of the evidence examining the role of H-FABP in early diagnosis and risk stratification of patients with CP and in non-ACS conditions associated with myocardial injury. Heart-type fatty acid-binding protein is a biomarker that is elevated early in myocardial injury The routine use in the emergency department complements the use of troponins in ruling out acute coronary syndromes in patients presenting early with chest pain It also is useful in risk stratifying patients with other conditions such as heart failure and acute pulmonary embolism. [ABSTRACT FROM AUTHOR]

Background/aim: Our aim in this study was to compare the efficacy and safety of crystalloid del Nido solution and cold blood cardioplegia solution on clinical and laboratory parameters. Materials and methods: Sixty patients who underwent elective coronary bypass operation between July 2019 and January 2020 were included in our study. Patients were divided into 2 groups of 30 patients using del Nido solution (DNS) and cold blood cardioplegia solution (CBCS), which were given for cardiac arrest. Demographic data, preoperative, postoperative 0th h, 6th h and 4th day creatine kinase myocardial band (CK-MB) and troponin I values were compared with a specific cardiac enzyme heart-type fatty acid-binding protein (H-FABP). Results: We found that aortic cross clamp duration and cardiopulmonary bypass (CPB) time were shorter in patients using del Nido solution than cold blood cardioplegia solution (57.30 ± 23.57 min, 76.07 ± 27.18 min, P = 0.006) (95.07 ± 23.06 min, 114.13 ± 33.93, P = 0.014). Total cardioplegia solution volume was higher in the cold blood cardioplegia solution group (1426.67 ± 416.00 vs. 1200 ± 310.73 P = 0.02). Preoperative and postoperative levels of cardiac enzymes including CK-MB, troponin I and H-FABP were comparable in del Nido solution and cold blood cardioplegia solution groups. Conclusion: According to these results, when we compare both demographic data and CK-MB, troponin I and H-FABP levels, both cardioplegia solutions were comparable regarding safety and efficacy in terms of myocardial protection. [ABSTRACT FROM AUTHOR]

Background: Heart-type fatty acid-binding protein (H-FABP) is a novel marker of myocardial injury and has been reported to be associated with cardiovascular diseases (CVD) including patients with diabetes mellitus (DM). Unfortunately, its prognostic value in patients with CVD and impaired glucose metabolism (IGM) is unclear. The objective of this study was to investigate the prognostic value of H-FABP in CVD patients with IGM. Methods: A total of 4594 patients with angiography-proven coronary artery disease (CAD) were enrolled and divided into subgroup according to glucose metabolism status (normal glucose regulation [NGR], pre-DM, and DM). Baseline levels of H-FABP were measured using latex immunoturbidimetric method. The cardiovascular events (CVE) were defined as cardiovascular death, myocardial infarction, stroke and coronary revascularization. Cox regression and Kaplan–Meier analysis were used to evaluate the relations of H-FABP and glucose metabolism status to CVEs. Results: During the follow-up period with up to 7.1 years, 380 CVEs occurred. Patients with CVE had higher levels of H-FABP compared to those without CVE (p < 0.001). Interestingly, H-FABP levels were also elevated in DM and pre-DM groups compared with NGR group (p < 0.001), when combined glucose metabolism status with H-FABP stratification, patients in the highest tertile of H-FABP appeared to have higher risk of CVEs with pre-DM (adjusted hazard ratio [HR]: 1.855, 95% confidential intervals [CIs] 1.076–3.214; p = 0.033) and DM (adjusted HR: 2.560, 95% CIs 1.409–4.650; p = 0.002). The Kaplan–Meier curve indicated that DM patients with the highest H-FABP levels were associated with the greatest risk of CVEs (p < 0.05). Conclusions: Our data firstly showed that elevated H-FABP levels were associated with worse outcomes in CAD patients with pre-DM and DM, which provided the novel information that H-FABP might be a prognostic marker for clinical outcomes among patients with CAD and IGM. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the use of H-FABP as a novel marker in early detection of cardiac damage (MI) in patients presenting with symptoms of the acute coronary syndrome (ACS). Methods: This cross-sectional study included 250 subjects; 125 patients of ACS presenting within four hours of the onset of chest pain and/dyspnea and 125 age and sex-matched healthy controls. An initial blood sample was taken from patients at presentation. Blood samples of healthy control subjects were also taken. The blood samples of both groups were centrifuged and stored at -200 C for H-FABP analysis. All the patients and control subjects were thoroughly examined and detailed history was taken. The diagnostic test was troponin-T.H-FABP concentrations of all samples were measured by ELISA-kit. The results were analyzed statistically. A p-value=0.05 was considered statistically significant. Results: In 125 patients of ACS, H-FABP showed a sensitivity of 85% and specificity of 83.3% for acute MI diagnosis at a cut-off level of 16 ng/ml. Positive predictive values and negative predictive values were 96.8% and 48.4% respectively. The accuracy was 84.4%and the area under the ROC curve was 0.842. Conclusion: Evaluation of heart-type fatty acid-binding Protein (H-FABP) within four hours of onset ACS symptoms may be a valuable tool in the diagnosis of AMI. [ABSTRACT FROM AUTHOR]

The research aimed to evaluate the association between heart-type fatty acid binding protein (H-FABP) and cardiovascular events. We systematically reviewed research that has been conducted to assess this relationship, aiming to determine how useful H-FABP could be as a biomarker for cardiovascular diseases, especially in the initial phases of acute myocardial infarction (AMI) and acute coronary syndrome (ACS). Our goal was to validate its diagnostic accuracy and clinical relevance. We systematically searched through PubMed, Web of Science, and Google Scholar databases to find pertinent publications related to cardiovascular diseases and H-FABP, using various permutations, abbreviations, and language variations of MeSH keywords. The final analysis included 12 studies in total. The final study comprised twelve studies, and it was concluded that H-FABP demonstrated high sensitivity (64.3-91.5) and specificity (73-100) for diagnosing Acute Myocardial Infarction (AMI) and Acute Coronary Syndrome (ACS), especially within the first hours of symptom onset. H-FABP demonstrates potential in enhancing the overall diagnostic accuracy during the initial hours following the manifestation of symptoms. However, the existing data do not provide sufficient evidence to recommend the regular utilization of H-FABP as a preliminary risk assessment approach in individuals who present with suspected cardiac events. Additional investigations, with well-defined prospective cohorts, are needed to validate the results observed., Competing Interests: Authors declare no conflict of interests in this study., (© 2024 The Author(s).)

Background: We analyzed the correlation between heart-type fatty acid-binding protein (HFABP) and the development of acute kidney injury (AKI) in patients with sepsis and estimated the predictive capacity of HFABP for sepsis-associated acute kidney injury (SAKI). Methods: In this retrospective observational study, we screened 2,452 patients who received the HFABP test in the emergency department. 442 admitted patients with sepsis were finally enrolled. Based on the diagnostic criteria for AKI in Kidney Disease: Improving Global Outcomes (KDIGO) guidelines, patients were divided into the no-AKI group (n = 317) and AKI group (n = 125). We analyzed the correlation between HFABP and SAKI occurrence by logistic regression analysis and evaluated the predictive ability of HFABP to SAKI using c-index, net reclassification improvement index (NRI) and integrated discrimination improvement index (IDI). Results: Patients in the AKI group with significantly higher the level of HFABP and in-hospital mortality. HFABP concentration is an independent risk factor for SAKI (OR: 11.398; 95% CI: 6.218–20.891, P < 0.001), but not for in-hospital mortality (OR: 1.189, 95%CI: 0.954–2.607, P = 0.076). The addition of HFABP to the prediction model significantly improved the ROC area (0.867 vs 0.755, P < 0.001), NRI 25.03% (95% CI 9.72–38.51%) and IDI 14.33 (95% CI 11.04–17.62). Conclusion: Serum HFABP is correlated with SAKI development and could become a potential predictive biomarker. [ABSTRACT FROM AUTHOR]

Aims: The importance of true worsening renal failure (WRF), which is associated with a poor prognosis, had been suggested in patients with acute heart failure (AHF). The aim of the present study was to establish the biomarker strategy for the prediction of true WRF in AHF. Methods and results: Two hundred eighty‐one patients with AHF were analysed. Their biomarkers were measured within 30 min of admission. Patients were assigned to the non‐WRF (n = 168), pseudo‐WRF (n = 56), or true‐WRF (n = 57) groups using the criteria of both acute kidney injury on admission and increasing serum creatinine value during the first 7 days. A Kaplan–Meier curve showed that the survival and heart failure event rate of the true‐WRF group within 1000 days was significantly lower than that of the non‐WRF and pseudo‐WRF groups (P ≤ 0.001). The multivariate Cox regression model also indicated that true WRF was an independent predictor of 1000 day mortality and heart failure events [hazard ratio: 4.315, 95% confidence interval (CI): 2.466–7.550, P ≤ 0.001, and hazard ratio: 2.834, 95% CI: 1.893–4.243, P ≤ 0.001, respectively]. The serum heart‐type fatty acid‐binding protein (s‐HFABP) levels were significantly higher in the true‐WRF group than in the non‐WRF and pseudo‐WRF groups (P ≤ 0.001). The multivariate logistic regression model indicated that the predictive biomarker for the true‐WRF group was the s‐HFABP level (odds ratio: 5.472, 95% CI: 2.729–10.972, P ≤ 0.001). The sensitivity and specificity for indicating the presence of true WRF were 73.7% and 76.8% (area under the curve = 0.831) for s‐HFABP in whole patients, respectively, and 94.7% and 72.7% (area under the curve = 0.904) in non‐chronic kidney disease (CKD) patients, respectively. Conclusions: Cardiac biomarkers, especially the s‐HFABP, might predict the development of true WRF in AHF patients. Furthermore, the predictive value was higher in AHF patients without CKD than in those with CKD. [ABSTRACT FROM AUTHOR]

OBJECTIVES: We aimed to compare the plasma levels of biomarkers such as: serum Gal-3, H-FABP, cTnI, and CK-MB in patients, who were admitted to the emergency room with chest pain, and to determine whether these biomarkers have early diagnostic value of acute coronary syndrome (ACS). METHODS: The study was performed in 60 patients aged = 18 years, who were admitted to emergency room. These patients were divided into 3 groups: patients with STEMI (group I, n = 20), patients with NSTEMI (group II, n = 20), and patients with USAP (group III, n = 20). Serum Gal-3, H-FABP, cTnI, and CK-MB levels were measured at admission, and at the 2nd and 4th hours. RESULTS: There were statistically significant differences between the groups in terms of Gal-3 levels at admission, and the 2nd and 4th hours (p = 0.007, p = 0.002, and p = 0.001, respectively). There were statistically significant differences between the groups in terms of H-FABP levels at admission, and the 2nd and 4th hours (p = 0.001, p = 0.003, and p = 0.003, respectively).There were statistically significant differences between the groups in terms of cTnI levels at admission, and the 2nd and 4th hours (p < 0.001, p < 0.001, and p < 0.001, respectively). CONCLUSIONS: According to the results of the study, cTnI, H-FABP, and Gal-3 are useful parameters that can be used in the early diagnosis of ACS (Tab. 4, Ref. 36). [ABSTRACT FROM AUTHOR]

Abstract Background Heart-type fatty acid-binding protein (H-FABP) is a cytoplasmic protein and is released form necrotic cardiac myocytes, as well as ischemic cardiac myocytes. In this study, we compared creatine kinase MB (CK-MB), H-FABP, and cardiac troponin T (cTnT) after coronary artery bypass grafting (CABG), heart valve surgery, or septal defect surgery to evaluate the difference in detecting myocardial injury between three markers. Methods A total of 69 patients (CABG, 32; valve surgery, 27; and septal defect surgery, 10) were prospectively enrolled. Blood samples were taken at specific intervals. Results Mean amount (AUC 0-72h) of CK-MB and cTnT released for 72 h in the patients with valve surgery were 2446 h·ng/ml and 93.2 h·ng/ml, which were significantly larger than those in the patients with CABG or septal defect surgery (p <.05). Mean amount (AUC 0-72h) of H-FABP released for 72 h in the patients with CABG was 1939 h·ng/ml, which was significantly larger than that in the patients with septal defect surgery (700.1 h·ng/ml) (p <.05). Conclusion H-FABP would be a more useful marker for detecting myocardial ischemic injury than CK-MB and cTnT. CK-MB and cTnT would be more sensitive to myocardial injury with surgical trauma than with ischemic injury in the patients with cardiac surgery. Highlights • Mean amounts of CK-MB and cTnT released in the patients with CABG was similar to septal defect surgery. • Mean amount of H-FABP released in the patients with CABG was significantly larger than septal defect surgery. • H-FABP would be a more useful marker for detecting myocardial ischemic injury than CK-MB and cTnT. [ABSTRACT FROM AUTHOR]

Aim. To evaluate the diagnostic value of heart-type fatty acid-binding protein (H-FABP) introduction to standard cardiac biomarkers in diagnostics of myocardial infarction (MI) early after clinical symptoms onset. Material and methods. Patients aged 18 years and older admitted to the hospital with acute coronary syndrome (ACS) during first 6 hours after ACS symptoms onset were enrolled into the study. At hospitalization level of biomarkers of myocardial damage (creatine phosphokinase-MB fraction - CPK-MB, troponin T) and qualitative tests on FABP were assessed in all patients. Serum troponin T concentration measured in 12 hours after the hospitalization was used to confirm diagnosis of MI. Moreover , diagnosis of MI was verified by echocardiography with the assessment of local reduction in myocardial contractility. Results. 101 patients were included into the study (27% female; aged 59.9±12.4). At the moment of hospitalization 71 (70%) patients were diagnosed with ACS with ST-segment elevation, and 30 (30%) patients - ACS without ST-segment elevation. In total, period between clinical symptoms onset and hospitalization was 3.6±1.4 hours. Analysis of diagnostic value of tests during the first 6 hours after ACS symptoms onset showed higher sensitivity of H-FABP in comparison with troponin T and CPK-MB (72.5, 56.2 and 49.5%, respectively). Specificity of these tests during the first 6 hours after onset of clinical signs of ACS was 90, 100 и 90%, respectively. Sensitivity and specificity were 87.7 and 100.0%, respectively , when H-FABP , troponin T and CPK-MB were used in combination as a “block test” in patients hospitalized during the first 6 hours after ACS symptoms onset. Sensitivity and specificity were 74.3 и 100.0%, respectively , when “block test” was used in patients hospitalized during the first 3 hours after ACS symptoms onset; between 3 and 6 hours after ACS symptoms onset sensitivity and specificity of tests reached 100%. Conclusion. “Block test” with H-FABP , troponin T and CPK-MB early after ACS symptoms onset is more sensitive in comparison with separate use of the tests.

Background: Heart-type fatty acid-binding protein (H-FABP) is an emerging biomarker, which was found to be sensitive for the early diagnosis of acute myocardial infarction (AMI). We prospectively investigated the usefulness of H-FABP determination for the evaluation of acute chest pain in patients arriving at the emergency department. Methods: Fifty-four patients presenting with acute ischemic chest pain were evaluated. H-FABP was estimated at admission using latex-enhanced immunoturbidimetric assay. Serial cardiac troponin I (cTnI), creatinine kinase-MB (CK-MB) determination, ischemia workup with stress testing, and/or coronary angiogram (CAG) were performed according to standard protocols. Results: The sensitivity and specificity of H-FABP was 89.7% and 68%, for cTnI it was 62.1% and 100%, and for CK-MB it was 44.8% and 92%, respectively for diagnosis of AMI. The sensitivity of H-FABP was found to be far superior to initial cTnI and CK-MB, for those seen within 6 h (100% vs. 46.1%, 33% respectively). On further evaluation of patients with positive H-FABP and negative cTnI, 71.4% of the patients had significant lesion on CAG, indicating ischemic cause of H-FABP elevation. Six patients with normal cTnI and CK-MB with high H-FABP had ST elevation on subsequent ECGs and were taken for primary angioplasty. Conclusion: H-FABP is a highly sensitive biomarker for the early diagnosis of AMI. H-FABP as early marker and cTnI as late marker would be the ideal combination to cover the complete diagnostic window for AMI. Detection of myocardial injury by H-FABP may also be applied in patients with unstable angina. H-FABP can also be used as a marker for early detection of STEMI before the ECG changes become apparent.

Introduction: The early identification of vulnerable pediatric cardiac surgery patients can help clinicians provide them with timely support. Heart-type fatty acid-binding protein. (H-FABP) is an early biomarker of myocardial injury in acute myocardial infarction in adults. In this study, we evaluated the correlations between postoperative H-FABP, creatine kinase-myocardial band (CK-MB), troponin-I, total bypass time, and clinical outcomes. Methods: In 32 pediatric patients that underwent ventricular septal defect. closure we measured H-FABP, troponin-I and CK-MB preoperatively and 1, 3, and 6 h after aortic declamping. Spearman's Rho correlations were calculated between laboratory and clinical parameters including inotropic support duration, aortic cross-clamp time, total bypass time, ventilation.weaning.time, and total Intensive Care Unit stay. Results: H-FABP, CK-MB, troponin-I, and total bypass time have a similarly weak to moderate correlation with clinical outcome measures. Conclusions: The predictive value of H-FABP for clinical outcome is not stronger than that of CK-MB, Troponin-I, or bypass times.

Fatty acid-binding proteins, whose clinical applications have been studied, are a family of proteins that reflect tissue injury. Heart-type fatty acid-binding protein (H-FABP) is a marker of ongoing myocardial damage and useful for early diagnosis of acute myocardial infarction (AMI). In the past decade, compared to other cardiac enzymes, H-FABP has shown more promise as an early detection marker for AMI. However, the role of H-FABP is being re-examined due to recent refinement in the search for newer biomarkers, and greater understanding of the role of high-sensitivity troponin. We discuss the current role of H-FABP as an early marker for AMI in the era of high sensitive troponin. H-FABP is highlighted as a prognostic marker for a broad spectrum of fatal diseases, viz., AMI, heart failure, arrhythmia, and pulmonary embolism that could be associated with poor clinical outcomes. Because the cut-off value of what constitutes an abnormal H-FABP potentially differs for each cardiovascular event and depends on the clinical setting, an optimal cut-off value has not been clearly established. Of note, several factors such as age, gender, and cardiovascular risk factors, which affect H-FABP levels need to be considered in this context. In this review, we discuss the clinical applications of H-FABP as a prognostic marker in various clinical settings. [ABSTRACT FROM AUTHOR]

Purpose: Overt hypothyroidism affects mostly women with an increasing prevalence with age. Hypothyroidism is associated with accelerated atherosclerotic cardiovascular diseases possibly caused by the higher incidence of hyperlipidemia, insulin resistance, and hypertension. Hearttype fatty acid-binding protein (H-FABP) is specific for cardiomyocytes and a sensitive marker of myocardial injury. The purpose of this study was examining the effect of hypothyroidism on H-FABP levels and carotid artery intima-media thickness (CIMT). Material and Method: We measured serum H-FABP levels in 33 patients with overt hypothyroidism and age, gender, and body mass indexmatched 39 control subjects. The patients were newly diagnosed with Hashimoto's thyroiditis. All participants underwent high-resolution B-mode ultrasonography for the measurement of CIMT. Results: There was no significant difference in serum levels of H-FABP between the patient group and controls (1515.87±2143.0 pg/mL vs. 953.0±416.0 pg/mL, respectively; p=0.15). CIMT level was significantly higher in the patient group than in the control group (0.53±0.08 mm vs. 0.48±0.05 mm; p=0.02). However, the homeostasis model assessment of insulin resistance and fasting insulin levels did not differ between the two groups. Discussion: Based on the results of this study, we assume that H-FABP is not a useful marker in detecting preclinical atherosclerosis in patients with overt hypothyroidism associated with Hashimoto's thyroiditis, however, CIMT might be a useful marker in detecting early atherosclerosis. [ABSTRACT FROM AUTHOR]

Objective To observe the changes in levels of troponin I (TnI), N-terminal pro-brain natriuretic peptide (NT-proBNP), heart-type fatty acid-binding protein (H-FABP) and myoglobin (MYO) in patients with chronic cardiorenal syndrome (CRS) and to find their biological markers for early cardiac damage. Methods Eight-three patients with non-dialysis chronic kidney disease (CKD) were divided into 4 groups, including 28 patients with stage 1-2 CKD without cardiorenal syndrome in group 1,14 patients with stage 3-4 CKD without CRS in group 2, 19 patients with stage 1-2 CKD with CRS in group 3, and 22 patients with stage 3-1 CKD with CRS in group 4. In addition, 20 healthy individuals where used as the control group. Fasting venous blood was collected from each group the levels of TnI, NT-proBNP, MYO and H-FABP in peripheral blood were measured, and the concentration ratio between H-FABP and MYO (F/M) was calculated. The renal function and related biochemical indexes were detected, and the cardiac structure and function was observed. Results There was no significant difference in TnI of the peripheral blood among these groups (all P>0.05). The NT-proB-NP levels in the control group and groups 1,2,3 and 4 were 20, 36, 159, 249 and 372 pg/mL, and significant difference was found between every two groups (all P <0. 05). MYO and H-FABP in the groups 2, 3 and 4 were higher than those in the group 1 and the control group, and group 2 was higher than group 1, group 4 was higher than group 3 (P < 0. 05). F/M in the groups 3 and 4 was higher than that in the groups 1, 2 and the control group (P <0. 05). Conclusions NT-proB-NP, H-FABP, MYO levels and F/M increase in CKD patients with chronic CRS. Changes in renal function have little effect on the F/M ratio, therefore, the F/M ratio could be used as a marker for early cardiac damage in CKD patients. [ABSTRACT FROM AUTHOR]

In the present study, we aimed to evaluate temporal changes in heart-type fatty acid-binding protein (h-FABP) and myocardial performance index (Tei index) following administration of 5-fluorouracil (5-FU), a chemotherapeutic agent associated with myocardial ischemia induced by coronary vasospasm. Thirty-two patients with cancer receiving their first 5-FU-based chemotherapy were included in the study. Prior to chemotherapy and 24 hours after the initiation of chemotherapy, all patients underwent a comprehensive echocardiographic examination. Blood samples were taken for h-FABP and troponin I (TnI) measurements at different time points during the first 24 hours of 5-FU administration. Postinfusion echocardiography revealed worsening in Tei index (0.37 ± 0.08 vs 0.43 ± 0.07, P < .001). Clinically overt cardiotoxicity was evident in 4 (12.5%) of our patient population. Heart-type fatty acid binding protein and TnI levels were within normal ranges at all time points. Our results suggest that ischemia coronary vasospasm due to 5-FU cardiotoxicity should be reviewed. Furthermore, Tei index might be a sensitive indicator of occult 5-FU cardiotoxicity. [ABSTRACT FROM AUTHOR]

Objectives: The relationship between markers of myocardial ischemia and severity of coronary artery disease (CAD) has been investigated in several studies. In this study, we examined the relationship between severity of CAD and heart-type fatty acid-binding protein (H-FABP), a new marker of ischemia in patients with non-ST-segment elevation acute coronary syndrome (ACS). Study design: This prospective study comprised 49 patients who were referred to the emergency room with a diagnosis of non-ST elevation myocardial infarction. Troponins, creatine kinase-MB, lactate dehydrogenase, and aspartate aminotransferase levels were measured quantitatively, while blood H-FABP levels were measured qualitatively in the 4th- 8th hour from the onset of symptoms. All patients underwent coronary angiography within 72 hours after admission. Clinical and coronary angiographic characteristics of patients with positive and negative values of H-FABP were compared. Gensini and SYNTAX scores were used to determine the severity of CAD. Results: There were no statistically significant differences in mean age, gender distribution, risk factors for CAD, ischemic changes on ECG, or Gensini and SYNTAX scores between the H-FABP-negative and -positive groups (p>0.05). The duration of chest pain in the H-FABP-positive group was significantly longer than in the negative group (p

PURPOSE Heart-type fatty acid binding protein (H-FABP) is a sensitive marker of myocardial injury and predictor of worse prognosis in patients with pulmonary embolism (PE). Assessment of right ventricular dysfunction and pulmonary artery obstruction index (PAOI) with computed tomography (CT) has been reported as a predictor of mortality in PE. Therefore, we aimed to assess the correlation between H-FABP and CT angiographic PAOI in PE patients at intermediate risk. MATERIALS AND METHODS Sixty-one patients (28 males; mean age, 62±17 years) with diagnosis of PE were included in this study. CT was performed in all patients, and the following parameters were evaluated: right ventricle/left ventricle ratio (RV/LV), pulmonary artery axial diameter, superior vena cava axial diameter, and PAOI determined with Qanadli score. Blood samples were assessed for H-FABP and troponin levels. Patients were followed for 30 days after discharge. RESULTS Mean PAOI was 57±18%. Eleven patients died during the follow-up period due to PE (18% mortality rate). H-FABP was positive in 21 patients (35%). There was no difference in CT parameters between patients with positive H-FABP and negative H-FABP. In addition, CT parameters were similar between patients who survived and those who did not. RV/LV ratio correlated with PAOI score. Among the biomarkers, troponin levels correlated with both RV/LV ratio and PAOI. H-FABP was an independent predictor of mortality. PAOI and RV/LV ratio did not predict 30-day mortality. CONCLUSIONAlthough H-FABP positivity confers a bad prognosis on PE patients at intermediate risk, PAOI did not predict mortality in this group.

The article deals with prospects of using recombinant horseradish peroxidase in analytical biochemistry and biotechnology. Problems of recombinant horseradish peroxidase cloning in different expression systems, possible approaches to their solution, advantages of recombinant recombinant horseradish peroxidase and recombinant horseradish peroxidase-fusion proteins for immunoassays are considered. Possibility for development of mediatorless bienzyme biosensor for peroxide and metabolites, yielding hydrogen peroxide during their transformations, based on co-adsorption of recombinant horseradish peroxidase and the appropriate oxidase was demonstrated. The possibility to produce a fully active recombinant conjugate of recombinant horseradish peroxidase with human heart-type fatty acid binding protein, which may be used in competitive immunoassay for clinical diagnosis of acute myocardial infarction, and recombinant conjugates (N- and C-terminus) of recombinant horseradish peroxidase with Fab-fragments of the antibody against atrazine, which may be applied for atrazine pesticides detection, are demonstra ted for the first time.

Objectives: The objective of this study was to evaluate the diagnostic value of heart-type fatty acid-binding protein (H-FABP) in patients with acute chest pain and compare it with standard cardiac markers. Methods: We undertook a prospective evaluation of 100 consecutive patients admitted with acute chest pain suggestive of acute coronary syndromes (ACS). Serum cardiac troponin I (cTnI), cardiac troponin T (cTnT), creatine kinase-MB (CK-MB) mass, myoglobin, and H-FABP were determined at presentation and 2, 4, 8–10, and 16–24 hours after presentation. The main outcome measure was the best sensitivity value within 6 hours after symptom onset. Results: H-FABP peak concentration occurred at 8 hours after symptoms onset and was the most sensitive early marker with 79.9% and 98% of patients with AMI identified at presentation and 2 hours after presentation respectively. The sensitivity of all other cardiac markers (CK-MB mass, cTnI, cTnT, and myoglobin) at presentation was < 62%. The negative predictive value of H-FABP (94%) was also superior to other markers within the first 2 hours of presentation. Myoglobin was the second most sensitive early marker at presentation. Peak sensitivity of cTnI, CK-MB mass, and cTnT were present at 4, 8–10, and 8–10 hours respectively after presentation. Conclusion:Combined measurement of H-FABP and cTnI on two occasions during the first 8 hours after symptom onset was sufficiently sensitive and specific for the early diagnosis of most patients with acute MI and may provide advantages over other cardiac marker combinations.

Objectives: The aim of this study was to assess the diagnostic and prognostic value of heart-type fatty acid-binding protein (H-FABP) in elective percutaneous coronary intervention (PCI) and compare it with standard cardiac markers. Methods: A prospective evaluation was done of 80 consecutive patients admitted for elective PCI. Serum cardiac troponin T (cTnT), cardiac troponin I (cTnI), creatine kinase-MB (CK-MB mass), myoglobin, and H-FABP were determined pre-angioplasty and 1, 2, 4, and 16–24 hrs post-angioplasty. Elevated cardiac markers were correlated with demographic, angiographic and procedural variables. Patients were followed up for 20–26 months. Results: H-FABP peaked early at 2 hours and was useful for the early detection of evolving AMI within 1–3 hours after angioplasty. Cardiac-TnI, myoglobin, H-FABP, CK-MB mass, and cTnT concentrations were elevated in 46.25%, 17.5%, 13.3%, 11.25%, and 7.5% respectively. Cardiac-TnI was the most sensitive marker for detecting all complications and was superior to all other markers. Elevated cardiac markers were correlated with old age (P < 0.02); chest pain ± ECG changes of ischaemia (P < 0.003); use of stents (P < 0.019) and major complications such as major dissection (P < 0.004); transient vessel closure (P < 0.022); bail out stent (P < 0.003), and AMI (P < 0.042). Elevated cardiac markers were associated with a reduction of event-free survival (16.92 versus 20.67 months, P < 0.03). Conclusion: Heart-type-FABP measurements at 1 hour (or thereafter) post-PCI may offer an early chance of detecting evolving AMI; cTnI was the most sensitive marker for the detection of major complications in patients undergoing PCI. Measurements of cTnI 16–24 hours post-PCI should be part of the routine management of patients following elective PCI.

Objectives: Heart-type fatty acid binding-protein (H-FABP) has been reported to be a potential novel biochemical marker for the early diagnosis of acute myocardial infarction (AMI). The effect of kidney diseases on the renal handling of H-FABP has not yet been fully evaluated. The aim of this study was to compare the effect of renal failure on the level of H-FABP and cardiac troponin (cTnT) concentrations. Methods: The study population was a small group of 16 patients with renal failure (6 females, 10 males aged 30-70 years) on routine regular haemodialysis or peritoneal dialysis. Results: The mean ±SD of serum urea and creatinine concentration in this group of patients was 19 ±9.6 mmol/L and 531.3 ±231.2 mmol/L respectively. H-FABP was increased in all 16 patients (81 ±53.3μg/L). The cTnT was increased ≥ 0.1μg/L in 8 patients (50%), ≥ 0.2μg/L in 5 patients (31.3%), and ≥ 0.3μg/L in 1 patient (6%). Conclusion: The diagnostic efficiency of H-FABP and cTnT for the diagnosis of AMI in the presence of renal failure may be limited and such patients may have high levels even in the absence of AMI.

Background: Our previous study suggested that heart-type fatty acid-binding protein (HFABP) levels were greatly elevated in the conditioned medium of explant culture of in-stent restenosis (ISR) tissue from diabetic minipigs compared with those of non-ISR tissue. We here verified this result in animal tissues and investigated the impact of HFABP overexpression in human aortic smooth muscle cells (hASMCs). Methods and Results: In Western blot and realtime RT-PCR, HFABP protein and mRNA levels were significantly higher in ISR than in non-ISR tissues from minipigs, and higher in the ISR tissue from diabetic minipigs than that from nondiabetic minipigs. The mRNA microarray and cellular effects of hASMC retroviral overexpression of HFABP and vector was analyzed. Compared with vector, HFABP transduction activates multiple signaling pathways (e.g. ad-ipokine, TGF-β, Toll-like receptor, Wnt, Hedgehog, ErbB and Notch) and promotes inflammation, growth and migration in hASMCs whereas the knockdown of HFABP by small hairpin RNA attenuates these effects. Conclusion: HFABP expression is significantly higher in ISR tissue than in non-ISR tissue from diabetic and nondiabetic minipigs. Overexpression of HFABP induces multiple pathway-related promotion of inflammation, growth and migration in vascular SMCs, suggesting a potential role in coronary artery ISR. [ABSTRACT FROM AUTHOR]

Background: Children with intractable epilepsy have chronic dysfunction of the autonomic nervous system causing myocardial ischemia. Heart‑type fatty acid‑binding protein (H‑FABP) is a sensitive biomarker for myocardial ischemia. Aims: We aimed to evaluate serum levels of H‑FABP during seizures compared to their interictal levels and healthy controls and changes in heart rate (HR) and HR variability (HRV) in epileptic children with intractable seizures. Materials and Methods: We included 30 epileptic seizures in 25 children with intractable epilepsy and 30 matched controls. They were subjected to video‑electroencephalography monitoring simultaneously with Holter electrocardiogram and measurement of H‑FABP. Results: Mean serum levels of H‑FABP were increased significantly in patients either in the ictal or interictal periods compared to that in the controls (P < 0.001 and P < 0.01, respectively). There is no significant difference in serum levels of the H‑FABP in the ictal and interictal periods. The basal time domain measures of HRV were significantly lower in the patient group compared to the control group. Conclusion: H‑FABP might suggest a degree of myocardial ischemia in intractable epilepsy. HRV is impaired in patients with refractory seizures. [ABSTRACT FROM AUTHOR]

This multicenter prospective study was conducted to assess high-sensitivity troponin T (hs-TnT) and other biomarkers to decide and predict culprit lesions indicated for emergency percutaneous coronary intervention (PCI) in patients with suspicious acute coronary syndrome (ACS). We have reported Hs-TnT is the most sensitive biomarker for earlier diagnosis and decision making in patients with suspected ACS. In this study, we had conducted subanalysis investigating the usefulness for prediction of ACS culprit lesion. The patients with suspicious ACS and initially negative whole-blood rapid troponin T test, who underwent coronary angiogram (CAG), were enrolled ( n = 74). Hs-TnT, quantitative assay for conventional troponin T (c-TnT), creatine kinase MB isozyme (CK-MB), and heart-type fatty acid-binding protein (H-FABP) were simultaneously measured. ACS culprit lesion was described as total occlusion, subtotal occlusion, and/or angiographical unstable lesion such as thrombosis, ulceration or irregularity. The CAG revealed that 49 cases had ACS lesions to be indicated for emergency PCI. The areas under the ROC curves and ROC-optimized cut-off of hs-TnT, c-TnT, CK-MB, and H-FABP were 0.75, 0.67, 0.68, and 0.75, respectively, and 18, 11, 2.0, and 4.6 ng/ml, respectively. In patients with total occlusion and 90-99 % of diameter stenosis (TIMI 2 or 3), hs-TnT could predict emergency PCI with significantly higher sensitivity compared with H-FABP (hs-TnT >14 ng/ml; 71 %, and H-FABP >6.2 ng/dl; 51 %, p = 0.021) and other biomarkers. Meanwhile, H-FABP displayed significant correlations with number of diseased vessels and presence of thrombotic lesion. The present study first revealed different characteristics of correlation between the angiographic culprit lesions and each cardiac biomarker. For prediction of ACS lesions requiring emergency PCI, hs-TnT had the highest sensitivity with satisfied analytical precision. [ABSTRACT FROM AUTHOR]

Background The association between ongoing myocardial damage and outcomes in patients with Brugada syndrome who had received an implantable cardioverter-defibrillator (ICD) is unclear. Methods Consecutive patients with Brugada syndrome ( n = 31, 50 ± 13 years) who had received an ICD were prospectively enrolled. Minor myocardial membrane injury [heart-type fatty acid-binding protein (H-FABP) >2.4 ng/mL] and myofibrillar injury (troponin T >0.005 ng/mL) were defined using receiver operating characteristic curves. Patients were followed for a median period of 5 years to an endpoint of appropriate ICD shock. Results Myocardial membrane injury (29%) and myofibrillar injury (26%) were similarly prevalent among patients with Brugada syndrome who had received ICDs. Appropriate ICD shocks occurred in 19% of patients during the follow-up period. Multivariate Cox regression analysis showed that serum H-FABP level >2.4 ng/mL, but not troponin T level, was an independent prognostic factor for appropriate ICD shock due to ventricular fibrillation [hazard ratio (HR) 25.2, 95% confidence interval (CI) 1.33–1686, p = 0.03]. Conclusions Evaluating myocardial damage using H-FABP may be a promising tool for predicting ventricular arrhythmia in patients with Brugada syndrome who have received ICDs. [ABSTRACT FROM AUTHOR]

Objective To evaluate the short-time prognostic value of combination of Heart-type fatty acid-binding protein (H-FABP) and simple Pulmonary Embolism Severity Index (sPESI) in normotensive patients with acute pulmonary embolism (APE). Methods One hundred and thirty normotensive patients with APE were enrolled. The plasma concentration of H-FABP was analyzed and the sPESI scores were calculated．Result 13 (10% ) patients had adverse 30-day outcome. The H-FABP ［OR, 4.96 （1.70-14.42）， = 0.003］ and sPESI ［OR, 9.50 （2.24-40.28）， = 0.002］ were predictors for short-term prognosis of normotensive APE. All of the 30 patients (23.1%) with sPESI score 0 and H-FABP＜6 滋g/L had no adverse 30-day outcome. The combination model of H-FABP ≥6 滋g/L with sPESI ≥1 point(s) was associated with increased prognostic sensitivity and negative predictive value, which both reached 100%．Conclusions The H-FABP assay and the sPESI are useful prognostic indicators for 30-day outcome of normotensive APE. The combination of the both predictors can yield additive prognostic information and particularly identify low-risk patients with APE. [ABSTRACT FROM AUTHOR]

Congestive heart failure (CHF) is the leading cause of morbidity and mortality in the elderly worldwide. Although many biomarkers associated with in heart failure, these are generally prognostic and identify patients with moderate and severe disease. Unfortunately, the role of biomarkers in decision making for early and advanced heart failure remains largely unexplored. Previous studies suggest the natriuretic peptides have the potential to improve the diagnosis of heart failure, but they still have significant limitations related to cut-off values. Although some promising cardiac biomarkers have emerged, comprehensive data from large cohort studies is lacking. The utility of multiple biomarkers that reflect various pathophysiologic pathways are increasingly being explored in heart failure risk stratification and to diagnose disease conditions promptly and accurately. MicroRNAs serve as mediators and/or regulators of renin-angiotensin-induced cardiac remodeling by directly targeting enzymes, receptors and signaling molecules. The role of miRNA in HF diagnosis is a promising area of research and further exploration may offer both diagnostic and prognostic applications and phenotype-specific targets. In this review, we provide insight into the classification of different biochemical and molecular markers associated with CHF, examine clinical usefulness in CHF and highlight the most clinically relevant., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: The rapid exclusion of acute myocardial infarction in patients with chest pain can reduce the length of hospital admission, prevent unnecessary diagnostic work-up and reduce the burden on our health-care systems. The combined use of biomarkers that are associated with different pathophysiological aspects of acute myocardial infarction could improve the early diagnostic assessment of patients presenting with chest pain. Methods: We measured cardiac troponin I, copeptin and heart-type fatty acid-binding protein concentrations in 584 patients who presented to the emergency department with acute chest pain. The diagnostic performances for the diagnosis of acute myocardial infarction and NSTEMI were calculated for the individual markers and their combinations. Separate calculations were made for patients presenting to the emergency department <3 h, 3–6 h and 6–12 h after chest pain onset. Results: For ruling out acute myocardial infarction, the net predictive values (95% CI) of cardiac troponin I, copeptin and heart-type fatty acid-binding protein were 90.4% (87.3–92.9), 84% (79.8–87.6) and 87% (83.5–90), respectively. Combining the three biomarkers resulted in a net predictive value of 95.8% (92.8–97.8). The improvement was most pronounced in the early presenters (<3 h) where the combined net predictive value was 92.9% (87.3–96.5) compared to 84.6% (79.4–88.9) for cardiac troponin I alone. The area under the receiver operating characteristic for the triple biomarker combination increased significantly (P < 0.05) compared to that of cardiac troponin I alone (0.880 [0.833–0.928] vs. 0.840 [0.781–0.898], respectively). Conclusions: Combining copeptin, heart-type fatty acid-binding protein and cardiac troponin I measurements improves the diagnostic performance in patients presenting with chest pain. Importantly, in patients who present early (<3 h) after chest pain onset, the combination improves the diagnostic performance compared to the standard cardiac troponin I measurement alone. [ABSTRACT FROM AUTHOR]

Objectives: To test the diagnostic accuracy for detecting an acute myocardial infarction (AMI) using highly sensitive troponin assays and a range of new cardiac biomarkers of plaque destabilisation, myocardial ischaemia and necrosis; to test the prognostic accuracy for detecting adverse cardiac events using highly sensitive troponin assays and this range of new cardiac biomarkers; and to estimate the cost-effectiveness of using highly sensitive troponin assays or this range of new cardiac biomarkers instead of an admission and 10- to 12-hour troponin measurement. Design: Substudy of the point-of-care arm of the RATPAC (Randomised Assessment of Treatment using Panel Assay of Cardiac markers) trial. Setting: The emergency departments of six hospitals. Participants: Prospective admissions with chest pain and a non-diagnostic electrocardiogram randomised to point-of-care assessment or conventional management. Interventions: Blood samples taken on admission and 90 minutes from admission for measurement of cardiac markers [cardiac troponin I (cTnI), myoglobin and creatine kinase MB isoenzyme (CK-MB)] by point-of-care testing. An additional blood sample was taken at admission and 90 minutes from admission for analysis of high-sensitivity cTnI (two methods) and cardiac troponin T (cTnT), myoglobin, heart-type fatty acid-binding protein (H-FABP), copeptin and B-type natriuretic peptide (NTproBNP). Main outcome measures: 1. Diagnostic accuracy compared with the universal definition of myocardial infarction utilising laboratory measurements of cardiac troponin performed at the participating sites together with measurements performed in a core laboratory. 2. Ability of biomarker measurements to predict major adverse cardiac events (death, non-fatal AMI, emergency revascularisation or hospitalisation for myocardial ischaemia) at 3 months' follow-up. 3. Comparison of incremental cost per quality-adjusted life-year (QALY) of different biomarker measurement strategies for the diagnosis of myocardial infarction. Results: Samples were available from 850 out of 1132 patients enrolled in the study. Measurement of admission myoglobin [area under the curve (AUC) 0.76] and CK-MB (AUC 0.84) was diagnostically inferior and did not add to the diagnostic efficiency of cTnI (AUC 0.90–0.94) or cTnT (AUC 0.92) measurement on admission. Simultaneous measurement of H-FABP and cTnT or cTnI did improve admission diagnostic sensitivity to 0.78–0.92, but only to the same level as that achieved with troponin measured on admission and at 90 minutes from admission (0.78–0.95). Copeptin (AUC 0.62) and NTproBNP (AUC 0.85) measured on admission were not useful as diagnostic markers. As a prognostic marker, troponin measured on admission using a high-sensitivity assay (AUC 0.73–0.83) was equivalent to NTproBNP measurement (AUC 0.77) on admission, but superior to copeptin measurement (AUC 0.58). From modelling, 10-hour troponin measurement is likely to be cost-effective compared with rapid rule-out strategies only if a £30,000 per QALY threshold is used and patients can be discharged as soon as a negative result is available. Conclusions: The measurement of high-sensitivity cardiac troponin is the best single marker in patients presenting with chest pain. Additional measurements of myoglobin or CK-MB are not clinically effective or cost-effective. The optimal timing for measurement of cardiac troponin remains to be defined. Copeptin measurement is not recommended. H-FABP requires further investigation before it can be recommended for simultaneous measurement with high-sensitivity troponin in patients with acute chest pain. Trial registration: ISRCTN37823923. Funding: This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 17, No. 15. See the HTA programme website for further project information.

Introduction: The early identification of vulnerable pediatric cardiac surgery patients can help clinicians provide them with timely support. Heart-type fatty acid-binding protein (H-FABP) is an early biomarker of myocardial injury in acute myocardial infarction in adults. In this study, we evaluated the correlations between postoperative H-FABP, creatine kinase-myocardial band (CK-MB), troponin-I, total bypass time, and clinical outcomes. Methods: In 32 pediatric patients that underwent ventricular septal defect closure we measured H-FABP, troponin-I and CK-MB preoperatively and 1, 3, and 6 h after aortic declamping. Spearman's Rho correlations were calculated between laboratory and clinical parameters including inotropic support duration, aortic cross-clamp time, total bypass time, ventilation-weaning-time, and total Intensive Care Unit stay. Results: H-FABP, CK-MB, troponin-I, and total bypass time have a similarly weak to moderate correlation with clinical outcome measures. Conclusions: The predictive value of H-FABP for clinical outcome is not stronger than that of CK-MB, Troponin-I, or bypass times. [ABSTRACT FROM AUTHOR]