Heart-Type Fatty Acid Binding Protein as a marker of reperfusion after thrombolytic therapy

James A de Lemos, Elliott M. Antman, David A. Morrow, Joan Llevadot, Robert P. Giugliano, Stephanie A. Coulter, Kristin C. Schuhwerk, Shake Arslanian, Carolyn H. McCabe, C. Michael Gibson, Nader Rifai

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Abstract

Accurate, rapid, and simple noninvasive measures of infarct-related artery (IRA) patency are needed to identify patients with failed coronary reperfusion for rescue percutaneous coronary intervention (PCI). Heart-type Fatty Acid Binding Protein (H-FABP) is a small, cytosolic protein found in high concentrations in the myocardium. We evaluated the efficacy of H-FABP as a marker for successful reperfusion after thrombolysis. Fifty-eight subjects from the TIMI 14 trial had H-FABP and myoglobin concentrations measured at baseline (immediately prior to thrombolysis) and 60, 90, and 180 min after thrombolysis. All patients underwent coronary angiography at 90 min. By 60 min after thrombolysis, median concentrations of H-FABP and myoglobin were significantly higher in patients with a patent IRA than in those with an occluded IRA (P<0.01 for each). Similarly, the 60 and 90 min/baseline H-FABP and myoglobin ratios were significantly higher among patients with a patent IRA (P<0.01 for each). There were no significant differences in marker concentrations or ratios between patients with TIMI grade 2 and TIMI grade 3 flow. The area under the ROC curve tended to be greater for the 60 and 90 min/baseline myoglobin ratios than for similar ratios of H-FABP (0.71 and 0.73 vs. 0.64 and 0.62; P=ns). In conclusion, successful reperfusion can be detected within the first 60 min after thrombolysis with either H-FABP or myoglobin. Despite a favorable kinetic profile, however, H-FABP does not appear to represent a significant advance over myoglobin in the noninvasive detection of reperfusion after thrombolysis. Copyright (C) 2000 Elsevier Science B.V.

Original languageEnglish (US)
Pages (from-to)85-97
Number of pages13
JournalClinica Chimica Acta
Volume298
Issue number1-2
DOIs
StatePublished - Aug 2000

Fingerprint

Fatty Acid-Binding Proteins
Thrombolytic Therapy
Reperfusion
Myoglobin
Arteries
Myocardial Reperfusion
Angiography
Percutaneous Coronary Intervention
Coronary Angiography
ROC Curve
Area Under Curve
Myocardium
Kinetics

Keywords

  • Fatty-acid binding protein
  • Myocardial infarction
  • Myoglobin
  • Reperfusion
  • Thrombolysis

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry

Cite this

de Lemos, J. A., Antman, E. M., Morrow, D. A., Llevadot, J., Giugliano, R. P., Coulter, S. A., ... Rifai, N. (2000). Heart-Type Fatty Acid Binding Protein as a marker of reperfusion after thrombolytic therapy. Clinica Chimica Acta, 298(1-2), 85-97. https://doi.org/10.1016/S0009-8981(00)00259-X

Heart-Type Fatty Acid Binding Protein as a marker of reperfusion after thrombolytic therapy. / de Lemos, James A; Antman, Elliott M.; Morrow, David A.; Llevadot, Joan; Giugliano, Robert P.; Coulter, Stephanie A.; Schuhwerk, Kristin C.; Arslanian, Shake; McCabe, Carolyn H.; Gibson, C. Michael; Rifai, Nader.

In: Clinica Chimica Acta, Vol. 298, No. 1-2, 08.2000, p. 85-97.

Research output: Contribution to journalArticle

de Lemos, JA, Antman, EM, Morrow, DA, Llevadot, J, Giugliano, RP, Coulter, SA, Schuhwerk, KC, Arslanian, S, McCabe, CH, Gibson, CM & Rifai, N 2000, 'Heart-Type Fatty Acid Binding Protein as a marker of reperfusion after thrombolytic therapy', Clinica Chimica Acta, vol. 298, no. 1-2, pp. 85-97. https://doi.org/10.1016/S0009-8981(00)00259-X
de Lemos, James A ; Antman, Elliott M. ; Morrow, David A. ; Llevadot, Joan ; Giugliano, Robert P. ; Coulter, Stephanie A. ; Schuhwerk, Kristin C. ; Arslanian, Shake ; McCabe, Carolyn H. ; Gibson, C. Michael ; Rifai, Nader. / Heart-Type Fatty Acid Binding Protein as a marker of reperfusion after thrombolytic therapy. In: Clinica Chimica Acta. 2000 ; Vol. 298, No. 1-2. pp. 85-97.
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abstract = "Accurate, rapid, and simple noninvasive measures of infarct-related artery (IRA) patency are needed to identify patients with failed coronary reperfusion for rescue percutaneous coronary intervention (PCI). Heart-type Fatty Acid Binding Protein (H-FABP) is a small, cytosolic protein found in high concentrations in the myocardium. We evaluated the efficacy of H-FABP as a marker for successful reperfusion after thrombolysis. Fifty-eight subjects from the TIMI 14 trial had H-FABP and myoglobin concentrations measured at baseline (immediately prior to thrombolysis) and 60, 90, and 180 min after thrombolysis. All patients underwent coronary angiography at 90 min. By 60 min after thrombolysis, median concentrations of H-FABP and myoglobin were significantly higher in patients with a patent IRA than in those with an occluded IRA (P<0.01 for each). Similarly, the 60 and 90 min/baseline H-FABP and myoglobin ratios were significantly higher among patients with a patent IRA (P<0.01 for each). There were no significant differences in marker concentrations or ratios between patients with TIMI grade 2 and TIMI grade 3 flow. The area under the ROC curve tended to be greater for the 60 and 90 min/baseline myoglobin ratios than for similar ratios of H-FABP (0.71 and 0.73 vs. 0.64 and 0.62; P=ns). In conclusion, successful reperfusion can be detected within the first 60 min after thrombolysis with either H-FABP or myoglobin. Despite a favorable kinetic profile, however, H-FABP does not appear to represent a significant advance over myoglobin in the noninvasive detection of reperfusion after thrombolysis. Copyright (C) 2000 Elsevier Science B.V.",
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AB - Accurate, rapid, and simple noninvasive measures of infarct-related artery (IRA) patency are needed to identify patients with failed coronary reperfusion for rescue percutaneous coronary intervention (PCI). Heart-type Fatty Acid Binding Protein (H-FABP) is a small, cytosolic protein found in high concentrations in the myocardium. We evaluated the efficacy of H-FABP as a marker for successful reperfusion after thrombolysis. Fifty-eight subjects from the TIMI 14 trial had H-FABP and myoglobin concentrations measured at baseline (immediately prior to thrombolysis) and 60, 90, and 180 min after thrombolysis. All patients underwent coronary angiography at 90 min. By 60 min after thrombolysis, median concentrations of H-FABP and myoglobin were significantly higher in patients with a patent IRA than in those with an occluded IRA (P<0.01 for each). Similarly, the 60 and 90 min/baseline H-FABP and myoglobin ratios were significantly higher among patients with a patent IRA (P<0.01 for each). There were no significant differences in marker concentrations or ratios between patients with TIMI grade 2 and TIMI grade 3 flow. The area under the ROC curve tended to be greater for the 60 and 90 min/baseline myoglobin ratios than for similar ratios of H-FABP (0.71 and 0.73 vs. 0.64 and 0.62; P=ns). In conclusion, successful reperfusion can be detected within the first 60 min after thrombolysis with either H-FABP or myoglobin. Despite a favorable kinetic profile, however, H-FABP does not appear to represent a significant advance over myoglobin in the noninvasive detection of reperfusion after thrombolysis. Copyright (C) 2000 Elsevier Science B.V.

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