Results of qualitative test on fatty acid binding cardiac protein in suspected acute coronary syndrome and various kidney function level

Aim. To evaluate diagnostic properties of qualitative tests for cardiac fraction of the fatty acid binding protein (cFABP) in patients hospitalized with suspected acute coronary syndrome (ACS), depending on glomerular filtration rate (GFR) level.

Material and methods. Totally, 465 patients included, admitted with ACS within 24 hours from onset. All patients underwent cFABP test with immune chromatographic express tests “CardioFABP” (Novosibirsk, Russia) and/or “CARD-INFO” (Obninsk, Russia), as the levels of serum creatinine with further GFR calculation. Assessment of diagnostic characteristics was done by the values of specificity, sensitivity, and diagnostic correctness, as well as overall positive and negative test results according to GFR.

Results. The analysis did not reveal significant difference in the number of positive and negative results of cFABP with the “CARD-INFO” (χ²=6,822, р=0,146), “CardioFABP” 10 ng/mL (χ²=4,968, р=0,291) and “CardioFABP” 15 ng/mL (χ²=8,673, р=0,07) in comparison by GFR. With coupled comparison, in the groups of patients by GFR there were differences in specificity for “CARD-INFO” (Fischer criteria =0,017, р˂0,05) and precision for “CardioFABP” (10 ng/mL) (χ²=5,793, р=0,017) in patients by GFR levels 60-90 and 30-59 mL/min/1,73 m². For the other parameters of diagnostical efficacy there were no differences by GFR. In severe renal dysfunction (GFR ˂15 mL/min/1,73 m²) results of qualitative cFABP were false positive in 10 cases among 11 (90,9%).

Conclusion. In patients hospitalized for suspected ACS, the results and diagnostic characteristics of the express-tests for cFABP “CARD-INFO” and “CardioFABP” depended mildly on GFR level with its values ≥15 mL/min/1,73 m². Low number of patients with GFR ˂15 mL/min/1,73 m² made not possible to acquire significant data on cFABP in this category of patients, however the data available make it not to apply the test in this category of patients.

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