Heart fatty acid binding protein, cardiac troponin I and creatine kinase in patients with acute coronary syndrome with ST-segment elevations subjected to thrombolytic therapy

Aim. To compare the diagnostic and prognostic values of a novel marker of m yocardial injury heart fatty acid binding protein (FABP), cardiac troponin I (cTn-l) and creatine kinase (CK) in patients with acute coronary syndrome with ST-segment elevations. Methods. Blood serum levels of FABP, cTn-l and CK were determined at admission (in 3,1+/-1,3 hours after onset of pain) a nd in 6, 12, 18, 24 and 48 hours after initiation of thrombolytic therapy i n 57 patients with clinically suspected myocardial infarction and ST-segmen t elevations. Concentrations of FABP, cTn-l and CK above 12 g/ml, 1,2 g/ml and 400 U/I, respectively, were considered as diagnostically meaningful ele vations. During 30 days the following events occurred: 1 death, 4 recurrent myocardial infarctions (MI) and 26 attacks of prolonged (>10 min) angina a t rest. Patients were followed up for 12-18 months. There were 6 cardiovasc ular deaths during follow-up. Results. Levels of FABP, cTn-I and CK were di agnostically elevated in 87,4, 28,1 and 13,3% of patients, respectively, at admission, and in 91,2, 84,4 and 70,2% of patients, respectively, in 6 hou rs after onset of administration of a thrombolytic. All 7 patients without diagnostic elevation of CK had elevated levels of FABP. Neither absolute le vels of FABP, cTn-I and CK at above mentioned time points, nor percentages of patients with their elevated levels were associated with events during i mmediate and long-term follow-up. Conclusion: Admission level of FABP in pa tients with suspected MI and ST segment elevations was more effective than cTn-I and especially CK for early confirmation of diagnosis of acute MI but failed to predict death and ischemic events during medium-term follow up.