Biochemical markers of ischaemia for the early identification of acute myocardial infarction without St segment elevation

Cardiology. 2000;94(4):254-61. doi: 10.1159/000047326.


Blood was collected on admission and after 1-2 h in 130 consecutive patients admitted with typical chest pain in order to assess the capacity of myoglobin, fatty-acid-binding protein (FABP), CK-MB mass, and troponin I (TnI) in the early identification of acute myocardial infarction (AMI) without ST elevation. Using the maximum value within 6 h of onset of symptoms, AMI was detected with a 90-95% sensitivity and a 81-94% specificity by FABP at a cut-off level 8-12 midrog/l, or 81-86% and 89-93%, respectively, by myoglobin at a cut-off level 70-90 microg/l. CK-MB mass and TnI had low sensitivity, albeit very high specificity. As almost all AMI patients were identified within 6 h, serial measurements of FABP or myoglobin ruled out AMI with a very high degree of certainty. Due to the low prevalence of AMI (16%), the positive predictive values were modest (47-73%), yet increasing the probability of AMI by a factor 3-4. Myoglobin and FABP are very useful markers in the early triage of chest pain patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood*
  • Carrier Proteins / blood
  • Creatine Kinase / blood
  • Creatine Kinase, MB Form
  • Electrocardiography*
  • Fatty Acid-Binding Protein 7
  • Fatty Acid-Binding Proteins
  • Female
  • Humans
  • Isoenzymes / blood
  • Male
  • Middle Aged
  • Myocardial Infarction / blood
  • Myocardial Infarction / pathology*
  • Myocardial Ischemia / blood
  • Myocardial Ischemia / pathology*
  • Myoglobin / analysis
  • Neoplasm Proteins*
  • Predictive Value of Tests
  • Prospective Studies
  • Sensitivity and Specificity
  • Troponin I / blood
  • Tumor Suppressor Proteins*


  • Biomarkers
  • Carrier Proteins
  • FABP7 protein, human
  • Fatty Acid-Binding Protein 7
  • Fatty Acid-Binding Proteins
  • Isoenzymes
  • Myoglobin
  • Neoplasm Proteins
  • Troponin I
  • Tumor Suppressor Proteins
  • Creatine Kinase
  • Creatine Kinase, MB Form