Plasma reference value of heart-type fatty acid-binding protein, the earliest available plasma biomarker of acute myocardial infarction


More rapid triaging of patients suspected for acute myocardial infarction (AMI) is needed to facilitate early initiation of appropriate therapy in patients with AMI and to exclude low-risk patients who can safely be sent home. Heart-type fatty acid-binding protein (H-FABP) is established to be the earliest available plasma marker for AMI diagnosis. There is a paucity of data on circulating levels of H-FABP in the general population. In this study we applied a H-FABP immunoassay with improved analytical performance to assess plasma H-FABP reference values in a relatively large group (n = 443) of healthy subjects aged 18-69 y. Mean (±SD) plasma H-FABP concentration was 1.7 ± 0.9 ng/mL, with somewhat higher values found in males than in females. Plasma H-FABP also increases with age, as previously reported. The 99th centile was obtained for subjects aged 41-69 years and amounted to 5.6 ng/mL.

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Glatz, J. and Mohren, R. (2013) Plasma reference value of heart-type fatty acid-binding protein, the earliest available plasma biomarker of acute myocardial infarction. Health, 5, 1206-1209. doi: 10.4236/health.2013.58163.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Hamm, C.W., Bassand, J.-P., Agewall, S., Bax, J., Boersma, E., Bueno, H., Caso, P., Dudek, D., Gielen, S., Huber, K., Ohmann, M., Petrie, M.C., Sonntag, F., Sousa Uva, M., Storey, R.F., Wijns, W. and Zahger, D. (2011) ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. European Heart Journal, 32, 2999-3054. doi:10.1093/eurheartj/ehr236
[2] Pelsers, M.M.A.L., Chapelle, J.P., Knapen, M., Vermeer, C., Muijtjens, A.M.M., Hermens, W.T. and Glatz, J.F.C. (1999) Influence of age and sex and day-to-day and within-day biological variation on plasma concentrations of fatty acid-binding protein and myoglobin in healthy subjects. Clinical Chemistry, 45, 441-443.
[3] Haltern, G., Peiniger, S., Bufe, A., Reiss, G., Gülker, H. and Scheffold, T. (2010) Comparison of usefulness of heart-type fatty acid binding protein versus cardiac troponin T for diagnosis of acute myocardial infarction. American Journal of Cardiology, 105, 1-9. doi:10.1016/j.amjcard.2009.08.645
[4] Kurz, K., Giannitsis, E., Becker, M., Hess, G., Zdunek, D. and Katus, H.A. (2011) Comparison of the new high sensitivity cardiac troponin T with myoglobin, h-FABP and cTnT for early identification of myocardial necrosis in the acute coronary syndrome. Clinical Research in Cardiology, 100, 209-215. doi:10.1007/s00392-010-0230-y
[5] Viswanathan, K., Kilcullen, N., Morrell, C., Thistlethwaite, S.J., Sivananthan, M.U., Hassan, T.B., Barth, J.H. and Hall, A.S. (2010) Heart-type fatty acid-binding protein predicts long-term mortality and re-infarction in consecutive patients with suspected acute coronary syndrome who are troponin-negative. Journal of the American College of Cardiology, 55, 2590-2598. doi:10.1016/j.jacc.2009.12.062
[6] Lippi, G., Mattiuzzi, C. and Cervellin, G. (2013) Critical review and meta-analysis on the combination of heart-type fatty acid binding protein (H-FABP) and troponin for early diagnosis of acute myocardial infarction. Clinical Biochemistry, 46, 26-30. doi:10.1016/j.clinbiochem.2012.10.016
[7] Ruff, C.T., Bonaca, M.P., Kosowsky, J.M., Conrad M.J., Murphy, S.A., Jarolim P., Donahoe, S.M., O’Donoghue, M.L. and Morrow, D.A. (2013) Evaluation of the diagnostic performance of heart-type fatty acid binding protein in the BWH-TIMI ED chest pain study. Journal of Thrombosis and Thrombolysis, in press. doi:10.1007/s11239-013-0870-7
[8] Niizeki, T., Takeishi, Y., Takabatake, N., Shibata, Y., Konta, T., Kato, T., Kawata, S. and Kubota, I. (2007) Circulating levels of heart-type fatty acid-binding protein in a general Japanese population: Effects of age, gender and physiological characteristics. Circulation Journal, 71, 1452-1457. doi:10.1253/circj.71.1452
[9] Bathia, D.P., Carless, D.R., Viswanathan, K., Hall, A.S. and Barth, J.H. (2009) Serum 99th centile values for two heart-type fatty acid binding protein assays. Annals of Clinical Biochemistry, 46, 464-467. doi:10.1258/acb.2009.009055
[10] Carless, D.R., Wnek, M., Knox, C., Harrison, K.R., Calder, N., Hall, A.S. and Barth, J.H. (2013) Clinical and analytical evaluation of an immunoturbidimetric heart-type fatty acid-binding protein assay. Scandinavian Journal of Clinical & Laboratory Investigation, 73, 48-53. doi:10.3109/00365513.2012.734396
[11] Wodzig, K.W.H., Pelsers, M.M.A.L., Van der Vusse, G.J., Roos, W. and Glatz, J.F.C. (1997) One-step enzyme-linked immunosorbent assay (ELISA) for plasma fatty acid-binding protein. Annals of Clinical Biochemistry, 34, 263-268.
[12] Roos, W., Eymann, E., Symannek, M., Duppenthaler, J., Wodzig, K.W.H., Pelsers, M.M.A.L. and Glatz, J.F.C. (1995) Monoclonal antibodies to human heart fatty acid-binding protein. Journal of Immunological Methods, 183, 149-153. doi:10.1016/0022-1759(95)00043-A
[13] Bruins Slot, M.H.E., Reitsma, J.B., Rutten, F.H., Hoes, A.W. and Van der Heijden, G.J.M.G. (2010) Heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction: A systematic review and metaanalysis. Heart, 96, 1957-1963. doi:10.1136/hrt.2010.208272
[14] Viswanathan, K., Hall, A.S. and Barth, J.H. (2012) An evidence-based approach to the assessment of heart-type fatty acid binding protein in acute coronary syndrome. Clinical Biochemistry Review, 33, 3-11.
[15] Tate, J.R. (2008) Troponin revisited 2008: Assay performance. Clinical Chemistry and Laboratory Medicine, 46, 1489-1500. doi:10.1515/CCLM.2008.292

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