Heart Fatty Acid-Binding Protein Offers Similar Diagnostic Performance to High-Sensitivity Troponin T in Emergency Room Patients Presenting With Chest Pain
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- Inoue Kenji
- Department of Cardiology, Juntendo University Nerima Hospital
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- Suwa Satoru
- Department of Cardiology, Juntendo University Shizuoka Hospital
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- Ohta Hiroshi
- Department of Cardiology, Itabashi Chuo General Hospital
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- Itoh Seigo
- Department of Cardiology, Juntendo University School of Medicine
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- Maruyama Sonomi
- Department of Cardiology, Juntendo University Nerima Hospital
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- Masuda Nobuhito
- Perseus Proteomics Incorporated
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- Sugita Manabu
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital
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- Daida Hiroyuki
- Department of Cardiology, Juntendo University School of Medicine
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Background: The aim of the present study was to evaluate the diagnostic accuracy of high-sensitivity troponin T (hsTnT) in patients with suspected acute coronary syndrome (ACS) in comparison to heart fatty acid-binding protein (H-FABP), high-sensitivity C-reactive protein, myeloperoxidase (MPO), and pentraxin 3 (PTX3). Methods and Results: Patients (n=432) with chest pain were recruited for the analysis. ACS was diagnosed in 298 patients (69%). The diagnostic accuracy of measurements obtained at presentation, as quantified by the area under the receiver operating curve (AUC), was highest for hsTnT (AUC=0.82; 95% confidence interval [CI]: 0.78-0.87) and H-FABP (AUC=0.83; 95%CI: 0.78-0.87). Sensitivity (87.9%) and negative likelihood (LH; 0.2) for hsTnT were the highest and lowest, respectively, but H-FABP had the highest specificity (78.5%) and positive LH (3.6). Among patients who presented within 2h after the onset of chest pain, MPO had the highest AUC (0.82; 95%CI: 0.69-0.94). Combined use of H-FABP and MPO measurements yielded a sensitivity of 69.2%, specificity of 84.2%, positive LH of 4.4, and negative LH of 0.4. Conclusions: The hsTnT assay offers excellent diagnostic performance to rule out ACS, but it is prone to false-positive results. H-FABP offers similar overall diagnostic performance, while the combination of H-FABP and MPO assays may improve the diagnosis of ACS, particularly in patients with recent onset of chest pain. (Circ J 2011; 75: 2813-2820)<br>
収録刊行物
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- Circulation Journal
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Circulation Journal 75 (12), 2813-2820, 2011
一般社団法人 日本循環器学会
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詳細情報 詳細情報について
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- CRID
- 1390282680079099520
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- NII論文ID
- 10030033303
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- NII書誌ID
- AA11591968
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- ISSN
- 13474820
- 13469843
- http://id.crossref.org/issn/13469843
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- PubMed
- 21937835
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- Crossref
- PubMed
- CiNii Articles
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- 使用不可