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H-fabp as early predictor of myocardial infarction

a myocardial infarction and early prediction technology, applied in the field of myocardial infarction diagnosis methods, can solve the problems of a relatively high proportion of false negatives, the presence of cardiovascular complications, and the limitations of myoglobin use for diagnosis of myocardial infarctions

Inactive Publication Date: 2010-06-24
ROCHE DIAGNOSTICS OPERATIONS INC
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Problems solved by technology

A particularly important risk is the presence of cardiovascular complication, especially of an acute cardiovascular event.
However, the use of myoglobin for the diagnosis of myocardial infarctions has some limitations.
However, there are still some problems related to the use of cardiac troponin as a diagnostic marker in patients with acute coronary syndrome.
Thus, within the first 0 to 6 hours of an acute cardiovascular event, the use of troponin as a biomarker for the diagnosis of myocardial infarction causes a relatively high proportion of false negative results.
Thus, a myocardial infarction might not be recognized by means of a cardiac troponin assay and this may result in a possibly inappropriate or delayed treatment.
This raises the possibility of an incorrect diagnosis, e.g., MI instead of UAP, resulting in a possibly harmful, wrong and / or delayed treatment.

Method used

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  • H-fabp as early predictor of myocardial infarction
  • H-fabp as early predictor of myocardial infarction

Examples

Experimental program
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Effect test

example 1

Myoglobin, H-FABP and Troponin T in Patients with Acute Coronary Syndrome

[0095]69 patients showing characteristic symptoms of ACS (e.g., chest pain) were examined. Blood samples were obtained within the first two hours after the onset of symptoms. For the diagnosis of a ST-elevated MI patients were examined by electrocardiography. Additionally, the troponin T concentration was determined with a troponin T assay with a detection limit of 0.01 ng / ml. Further blood samples were obtained from patients for whom a diagnosis STEMI or NSTEMI could not be made (TnT concentration larger 0.01 but lower than 0.1 ng / ml, thus, levels which indicate necrosis). A troponin T level of larger than 0.1 ng / ml in a sample that was obtained at least 6 hours after the onset of symptoms was considered as being indicative for the recent occurrence MI (MI-converter), otherwise UAP was diagnosed (Non-MI-converter).

[0096]In a later analysis, the TnT, myoglobin and H-FABP concentration in samples from patients f...

example 2

Myoglobin, H-FABP and Troponin T in Patients with Stable Coronary Heart Disease

[0097]Myoglobin, H-FABP and sensitive troponin T were determined in blood samples of a total of 234 patients with stable coronary heart disease. The patients did not apparently suffer from an acute coronary event. H-FABP was determined as specified above. Troponin T was determined by a highly-sensitive troponin T test with a detection limit of 0.002 ng / ml. Patients were subjected to a detailed cardiologic investigation including echocardiography and coronary angioplasty. The coronary heart disease was subclassified into 1-, 2- or 3-vessel diseases, whereby stenosis of more than 50% should occur per vessel. The results are shown in the following tables.

TABLEH-FABP quartiles in patients with documented stable coronary heart disease.H-FABP [pg / ml] N = 2341. Quartil2. Quartil3. Quartil4. QuartilN60555960Median H-FABP pg / ml1132.11870.02636.54086.8Range0-15501565-2208 2223-33373357-46370Age, median61646671Coron...

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Abstract

The present invention relates to a method for diagnosing myocardial infarction in a subject who suffers from acute coronary syndrome and has a cardiac troponin level which is detectable but lower than the level that is considered as being indicative for a myocardial infarction. Moreover, the present invention relates to a method for identifying a subject being susceptible to cardiac intervention, wherein the subject suffers from acute coronary syndrome and has a cardiac troponin level which is detectable but lower than a level that is considered as being indicative for a myocardial infarction. The methods of the present invention are based on the determination of H-FABP and, optionally, myoglobin in a sample of the subject and comparing the amount of H-FABP and, optionally, myoglobin to reference amounts.

Description

RELATED APPLICATIONS[0001]This application is a continuation of PCT / EP2008 / 056603 filed May 29, 2008 and claims priority to EP 07116337.2 filed Sep. 13, 2007 and EP 07109141.7 filed May 29, 2007.FIELD OF THE INVENTION[0002]The present invention relates to a method for diagnosing myocardial infarction in a subject who suffers from acute coronary syndrome and has a cardiac troponin level, which is detectable, but lower than the level that is considered as being indicative for a myocardial infarction. Moreover, the present invention relates to a method for identifying a subject being susceptible to cardiac intervention, wherein the subject suffers from acute coronary syndrome and has a cardiac troponin level which is detectable, but lower than a level that is considered as being indicative for a myocardial infarction. The methods of the present invention are based on the determination of heart-type fatty acid binding protein (H-FABP) and, optionally, myoglobin in a sample of said subje...

Claims

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Application Information

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IPC IPC(8): G01N33/68G01N33/53
CPCG01N2800/324G01N33/6893
Inventor HESS, GEORGHUEDIG, HENDRIKKIENTSCH-ENGEL, ROSEMARIEZDUNEK, DIETMAR
Owner ROCHE DIAGNOSTICS OPERATIONS INC
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