A New Heart Test Could Save Lives

A new diagnostic blood test searches for proteins that are released into the circulation following myocardial ischemia (MI), aiding the diagnosis of patients admitted to hospital with acute coronary symptom (ACS).

Researchers at the University of Leeds (United Kingdom) examined fatty acid-binding protein (H-FABP) levels in 1,448 patients who presented ACS. The H-FABP level was measured 12 to 24 hours after onset of symptoms. The main outcome measure of the study was all-cause mortality one year after hospital admission. Multivariate analyses were conducted using the Global Registry of Acute Coronary Events (GRACE) variables together with troponin I and highly sensitive C-reactive protein (hs-CRP).

Study results showed that after 12 months of follow-up, 296 patients had died. Multivariate analysis demonstrated that H-FABP quartiles were strongly predictive of outcome. The crude all-cause 1-year mortality for unstable angina patients with H-FABP levels of less than 5.8 microgram/liter was 2.1% compared with 22.9% for patients above this cutoff level. The researchers suggest that the new blood test could be used by ambulance crews to test people on the way to hospital, and to aid casualty departments who regularly see patients presenting with ACS. The study was published in the November 20, 2007, edition of the American Journal of Cardiology.

"The H-FABP test is a major advance on what we had before. It appears to be able to detect milder and earlier degrees of heart injury than do current tests which detect heart cell death,” said co-author Dr. Alistair Hall, M.D., Ph.D. a professor of clinical cardiology.

The most commonly-used diagnostic tool today is the troponin test, which measures troponin, a complex of three proteins that is integral to muscle contraction in skeletal and cardiac muscle, but not smooth muscle. However, the troponin test can give both false-negative and false-positive results, meaning some patients are unnecessarily admitted, and others wrongly discharged.


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