Ab Rahman, Nik Hisamuddin Nik
(2011)
Clinical evaluation of i-step qualitative heart-specific fatty acid binding protein (h-fabp) test (cardiodetect®) and quantitative cardiac troponin t,
for the diagnosis of acute myocardial infarction in the emergency department.
Clinical evaluation of i-step qualitative heart-specific fatty acid binding protein (h-fabp) test (cardiodetect®) and quantitative cardiac troponin t, for the diagnosis of acute myocardial infarction in the emergency department.
Abstract
Objective
To assess the diagnostic indices of the CardioDetect assay and the quantitative cardiac
troponin T test, in diagnosing AMI in the ED, according to the time of onset of chest
pain.
Methodology
A total of eighty eligible patients presenting with ischemic type chest pain with duration
of symptoms within the last 36 hours were enrolled. All patients were tested for H-FABP
and Troponin T at presentation to ED. A repeated Cardiodetect test was performed one
hour after the initial negative result, and a repeated Troponin T test was also performed 8-
12 hours after an initial negative result. The diagnostic indices [sensitivity, specificity,
positive predictive value, negative predictive value, receiver operating curve (ROC)]
were analysed for CardioDetect and Troponin T (individually and in combination), and
also for the repeat CardioDetect test. Data entry and analysis was performed using SPSS
version 12.0 and analyse-it software.
Results
The CardioDetect test was more sensitive and had a higher NPV than troponin T (TnT)
test during the first 12 hours of onset of chest pain. The repeat CardioDetect had better
sensitivity and NPV than the initial CardioDetect. The sensitivity and NPV of the
combination test (CardioDetect and troponin T) was also superior to the each test
performed individually.
Conclusion
CardioDetect test is more sensitive and has a better NPV than Troponin T during the first
12 hours of AMI. It may be used to rule out myocardial infarction during the early phase
of ischemic chest pain.
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