According to the article in Clin Chem 46 No.4 2000 pg 718-719, Heart-Type Fatty Acid- Binding Protein is not totally heart specific nor does it demonstrate the sensitivity and specificity to detect AMI significantly earlier than do the existing markers.
Tibor Annus
Chief Scientist
Biochemistry Dept
Fremantle Hospital
-----Original Message-----
From: Chris Budgen [mailto:[log in to unmask]]
Sent: Wednesday, 10 September 2003 4:24 AM
To: [log in to unmask]
Subject: Re: SERUM MYOGLOBIN
Has anyone started using hFABP kits (rennesens make 'em) to screen for
ACS? heart Fatty Acid Binding Protein is supposedly heart specific and
starts increasing 15 minutes post cardiac event. rennesens market this
as a home test screening tool for patients at high risk.
Chris Budgen (Mr)
POCT Coordinator
Canterbury Health Laboratories
Christchurch
New Zealand
Internal ext. 81850
DDI: 03 364 1850
Cell phone: 025 973 645
email: [log in to unmask]
http://www.cdhb.govt.nz/chlabs/Staff2/chrisbudgen.htm
=============================================
>>> Myers Martin <[log in to unmask]> 10/09/03 01:49:05 >>>
Thanks to all that replied to my question about the use of serum
myoglobin
to rule out ACS.
The background to the question is that our clinicians are keeping low
risk
patients in for 12 hours to wait for a cTnT- and then discharging on
the
basis of a normal cTnT. The impression is that this uses more bed
resources
than before cTnT was introduced. Their question was whether a
biochemical
test could be used to rule OUT ACS in low risk patients (based on ECG
and
Clinical assessment) and send the patient home earlier than 12 hours.
The replies I received confirmed my view that serum myoglobin does not
have
either the sensitivity or specificity to RULE OUT ACS at 6 hours. I
received one reply where two serial CKMB mass measurements, one on
admission
(0 h) and a second 6 h later is being used for ruling out acute MI in
low
risk patients. One reply indicated that Cobalt Binding Albumin may be
a
future marker to address the early rule out issue.
In practice, from the replies I got, and the lack of suggestion that I
was
years out of date!, it appears that a biochemical test to rule out ACS
and
send a patient home at 6 hours is not common practice despite this
being
suggested in reviews and papers
regards
martin myers
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