응급실로 내원한 급성 심근경색증 환자에서 h-FABP (heart-type fatty acid-binding protein)의 진단적 의의 (The Diagnostic Value of h-FABP (hearttype fatty acid binding protein) in Acute Myocardial Infarction)

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 20권 / 2호 / 163 ~ 169페이지
· 저자명 : 김영준, 김현, 박승민, 차경철, 이강현, 황성오

초록

Purpose: Heart-type fatty acid binding protein (h-FABP) is
a low molecular weight (15 kDa) protein that is abundant in
the cytosol and is in high concentration in the myocardium.
H-FABP is released into plasma and urine early (within 1~2
hr) after onset of myocardial injury. This study was undertaken
to assess the diagnostic value of a h-FABP kit.
Methods: We conducted a prospective study of 73 patients
who were suspected to have acute myocardial infarction
and arrived within 24 hrs after the onset of chest pain from
March to August 2007. Exclusion criteria were age less
than 18 years and chronic renal failure.
Results: Thirty-nine patients arrived within 4 hrs (63%) and
23 arrived from 4hrs to 24hrs (37%). Upon initial EKG, ST
elevation was seen in 45 cases (72%), ST depression in 7
cases (11%), T-wave inversion in 4 (6%), and arrhythmia in
5 (8%). With respect to Killip classification, 33 cases were
class I (53%), 18 cases were class II (29%), 4 cases were
class III (6%), and 7 cases were class IV (11%). Diagnosis
was AMI in 49 cases (79%), unstable angina in 6 cases
(9%), and vasospasm in 1 case (1%). Sensitivity of FABP
was 71.0% on arrival at an emergency department within 4
hrs, which is higher than the sensitivities of myoglobin
(48.4%), CK-MB (48.4%), and troponin-I (38.7%).
Conclusion: H-FABP is more useful than other currently
available biomarkers for early detection of acute myocardial
infarction patients within 4 hrs of arrival at an emergency
department.

영어초록

Purpose: Heart-type fatty acid binding protein (h-FABP) is
a low molecular weight (15 kDa) protein that is abundant in
the cytosol and is in high concentration in the myocardium.
H-FABP is released into plasma and urine early (within 1~2
hr) after onset of myocardial injury. This study was undertaken
to assess the diagnostic value of a h-FABP kit.
Methods: We conducted a prospective study of 73 patients
who were suspected to have acute myocardial infarction
and arrived within 24 hrs after the onset of chest pain from
March to August 2007. Exclusion criteria were age less
than 18 years and chronic renal failure.
Results: Thirty-nine patients arrived within 4 hrs (63%) and
23 arrived from 4hrs to 24hrs (37%). Upon initial EKG, ST
elevation was seen in 45 cases (72%), ST depression in 7
cases (11%), T-wave inversion in 4 (6%), and arrhythmia in
5 (8%). With respect to Killip classification, 33 cases were
class I (53%), 18 cases were class II (29%), 4 cases were
class III (6%), and 7 cases were class IV (11%). Diagnosis
was AMI in 49 cases (79%), unstable angina in 6 cases
(9%), and vasospasm in 1 case (1%). Sensitivity of FABP
was 71.0% on arrival at an emergency department within 4
hrs, which is higher than the sensitivities of myoglobin
(48.4%), CK-MB (48.4%), and troponin-I (38.7%).
Conclusion: H-FABP is more useful than other currently
available biomarkers for early detection of acute myocardial
infarction patients within 4 hrs of arrival at an emergency
department.

참고자료

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