TY - JOUR T1 - Heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction: a systematic review and meta-analysis JF - Heart JO - Heart SP - 1957 LP - 1963 DO - 10.1136/hrt.2010.208272 VL - 96 IS - 24 AU - Madeleine H E Bruins Slot AU - J B Reitsma AU - Frans H Rutten AU - Arno W Hoes AU - Geert J M G van der Heijden Y1 - 2010/12/15 UR - http://heart.bmj.com/content/96/24/1957.abstract N2 - 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. ER -