Pre-hospital detection of acute myocardial infarction with ultra-rapid human fatty acid-binding protein (H-FABP) immunoassay

Int J Cardiol. 2007 Jul 31;119(3):349-54. doi: 10.1016/j.ijcard.2006.09.003. Epub 2006 Nov 13.


Aims: To evaluate the diagnostic performance of a portable semi-quantitative whole blood immunoassay measuring soluble human fatty acid-binding protein [H-FABP] (CardioDetect) for the pre-hospital detection of myocardial infarction (MI).

Methods and results: We enrolled prospectively 108 consecutive patients with acute ischemic type chest pain in whom the first medical care was delivered by a mobile intensive care unit (MICU). CTnI, myoglobin, CK-MB and CardioDetect were first assessed in the MICU before hospital admission using point-of-care assays and then cTnI was serially measured during the hospital stay. MI was defined as a positive cTnI in any sample over the first 24 h. The vast majority of the patients (77/108) were admitted <3 h of symptoms onset. Pre-hospital cTnI sample was normal in 96 patients (88.9%) of whom 43 had subsequent cTnI elevation. A positive H-FABP using the CardioDetect assay had a significantly better sensitivity than cTnI, myoglobin and CK-MB (87.3% vs 21.8%, 64.2% and 41.5%, respectively) to identify MI. The significant better sensitivity of the CardioDetect assay was also observed among patients who presented <3 h of symptom onset. The specificity of the CardioDetect assay was significantly better than that of myoglobin, irrespective of the time delay from symptom onset to measurement. In patients with normal pre-hospital cTnI and no ST-elevation (n=63), assessment based only on a positive H-FABP had 83.3% sensitivity, 93.3% specificity for the diagnosis of an evolving MI.

Conclusion: Early assessment of H-FABP in patients presenting with chest pain improves the diagnosis of ongoing MI.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Creatine Kinase, MB Form / blood
  • Emergency Medical Services*
  • Fatty Acid Binding Protein 3
  • Fatty Acid-Binding Proteins / blood*
  • Female
  • Humans
  • Immunoassay / methods*
  • Male
  • Middle Aged
  • Myocardial Infarction / blood*
  • Myocardial Infarction / diagnosis*
  • Myoglobin / blood
  • Point-of-Care Systems*
  • Sensitivity and Specificity
  • Troponin I / blood


  • FABP3 protein, human
  • Fatty Acid Binding Protein 3
  • Fatty Acid-Binding Proteins
  • Myoglobin
  • Troponin I
  • Creatine Kinase, MB Form