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      • Slide Session : OS-CAD-04 ; Cardiology : Effi cacy of Heart Type Fatty Acids Binding Protein Qualitative Evaluation in Early Diagnosis of Acute My-ocardial Infarction: One More Evidence

        ( Valentin Alexandrovich Kokorin ),( Anatoly Ivanovich Martynov ),( Andrey Alexandrovich Spassky ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

        Background: early diagnosis improves prognosis in acute coronary syndrome (ACS). Currently applied myocardial necrosis markers are not effective enough in early stages of ACS. Multicenter investiGation of clinlcal efficacy of eArly diagNosis of myocardial infarcTion with cardiac protein, binding fatty acids (GIANT) showed that express-test for qualitative evaluation of heart type fatty acid binding protein (hFABP) is more effective than troponin in patients admitted with suspected ACS. Pre-hospital efficacy of such tests remains unclear. Purpose: to evaluate efficacy of qualitative measurement of hFABP for differential diagnosis of ACS in ambulance service practice. Methods: 759 patients (387 men and 372 women, mean age 68, 3±0,5 y.o.) with suspected ACS and occurrence of chest pain 1-12 hours were enrolled in the study by 88 ambulance crews of Moscow station of emergency and first medical aid named after A.S. Puchkov. HFABP concentration was evaluated with qualitative immunochromatographic test <CardioFABP> (Biotest, Russia) before admission. 642 patients (84,6%) had acute myocardial infarction, 117 (15,4%) - other reasons of chest pain.Results: overall sensitivity of CardioFABP test was 88%, specificity - 92%, accuracy - 87%, positive predictive value - 99%, negative predictive value - 57%. In patients with ST-segment elevation (n=503) sensitivity of the test was 89%, specifi city - 65%, accuracy - 89%, positive predictive value - 99%, negative predictive value - 18%. In patients without ST-segment elevation (n=237) sensitivity of hFABP test was 86%, specificity - 82%, accuracy - 84%, positive predictive value - 88%, negative predictive value - 80%. Characteristics of the test did not differ significantly in intervals 1-6 and 6-12 hours. Conclusion: express-test for qualitative evaluation of hFABP has high efficacy in pre-hospital differential diagnosis of ACS and can be recommended for ambulance practice.

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