Use of a Whole Blood Rapid Panel Test for heart-type fatty acid–binding protein in patients with acute chest pain: comparison with Rapid Troponin T and Myoglobin Tests

Purpose We sought to determine the clinical utility of a newly developed qualitative test to measure heart-type fatty acid–binding protein levels in blood for the early identification of myocardial infarction. Methods We measured heart-type fatty acid–binding protein levels in 371 consecutive patients with acute chest pain and suspected myocardial infarction, and compared the performance of this test with those of troponin T and myoglobin tests. Levels of heart-type fatty acid–binding protein ≥6.2 ng/mL were considered as positive results. Results A final diagnosis of acute myocardial infarction was made in 181 patients (49%). Of the 68 patients who presented within 2 hours of the onset of symptoms, 37 (54%) had a final diagnosis of myocardial infarction. The sensitivity of the rapid heart-type fatty acid–binding protein test was 89% (33/37), significantly higher than for troponin T (22% [8/37]; P<0.001) and myoglobin (38% [14/37]; P<0.001). However, the specificity of troponin T (94% [29/31]) was significantly better than for heart-type fatty acid–binding protein (52% [16/31]; P= 0.002) within 2 hours. The area under the receiver operating characteristic curve for heart-type fatty acid–binding protein levels was greater than that for myoglobin (0.72 vs. 0.61, P = 0.01) among patients who presented within 2 hours. Conclusion A novel whole blood rapid heart-type fatty acid–binding protein test can be useful in the early evaluation of patients who present with acute chest pain.