Zeren Gönül, Erer Hatice Betül, Kırış Tuncay, Sahin Osman, Aksu Hüseyin, Köprülü Diyar, Güvenç Tolga Sinan, Erdoğan Güney, Sayar Nurten, Günaydın Zeki Yüksel, Eren Mehmet
Department of Cardiology, Ordu State Hospital, Ordu, Turkey.
Turk Kardiyol Dern Ars. 2013 Oct;41(7):610-6. doi: 10.5543/tkda.2013.26974.
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).
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.
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<0.001). Troponin, CK-MB, and AST levels as well as thrombolysis in myocardial infarction (TIMI) risk scores were found to be significantly higher in the H-FABP-positive group (p<0.05).
H-FABP is a useful marker for the diagnosis and risk evaluation of patients with non-ST elevation ACS. However, it is insufficient in evaluating the severity of CAD.
多项研究探讨了心肌缺血标志物与冠状动脉疾病（CAD）严重程度之间的关系。在本研究中，我们研究了CAD严重程度与心型脂肪酸结合蛋白（H-FABP）之间的关系，H-FABP是一种用于非ST段抬高型急性冠状动脉综合征（ACS）患者缺血的新标志物。
这项前瞻性研究纳入了49例因诊断为非ST段抬高型心肌梗死而被送往急诊室的患者。定量测定肌钙蛋白、肌酸激酶-MB、乳酸脱氢酶和天冬氨酸转氨酶水平，同时在症状发作后第4至8小时定性测定血液H-FABP水平。所有患者在入院后72小时内接受冠状动脉造影。比较H-FABP阳性和阴性患者的临床和冠状动脉造影特征。采用Gensini评分和SYNTAX评分来确定CAD的严重程度。
H-FABP阴性和阳性组在平均年龄、性别分布、CAD危险因素、心电图缺血改变或Gensini评分和SYNTAX评分方面无统计学显著差异（p>0.05）。H-FABP阳性组的胸痛持续时间明显长于阴性组（p<0.001）。发现H-FABP阳性组的肌钙蛋白、CK-MB和AST水平以及心肌梗死溶栓（TIMI）风险评分显著更高（p<0.05）。
H-FABP是用于非ST段抬高型ACS患者诊断和风险评估的有用标志物。然而，它在评估CAD严重程度方面并不充分。
