الفهرس | Only 14 pages are availabe for public view |
Abstract Acute coronary syndromes are currently one of the leading causes of death in industrialized countries & are expected to become so in emerging countries by 2020. Management of patients presented with ST elevation myocardial infarction is rapid reperfusion either by primary PCI or firinolysis while patients presented with non ST acute coronary syndromes varies according to the risk stratification of the patients from conservative management, early invasive & very early invasive strategy The aim of the study was to assess the usefulness of using heart-type fatty acid binding protein (H-FABP) as an early diagnostic biochemical marker for NSTEMI in patients with NSTE-ACS in comparison to Troponin and as regard sensitivity, specificity and time of early detection. This is for proper and optimal management. The study included 61 patients who presented to ER by typical chest pain within the first 4 hours from its onset. The population in the study underwent detailed history taking, clinical examination and ECG monitoring. All patients had normal kidney functions tests. Blood samples for H-FABP and Troponin and were obtained on admission for patients presenting to ED within the first 4 hours of onset of chest pain.Patients with negative Troponin test in first set, had a second set assessment after 6 hours. Sensitivity and specificity of HFABP was calculated in detection of myocardial ischemia and necrosis to all population included in the study in comparison to Troponin. Our study showed sensitivity of 89.36% for FABP, It showed also specificity of 100 % FABP. We conclude that qualitative assessment of H-FABP showed good sensitivity and specificity in early detection and diagnosis of NSTEMI cases from all patients presented with NSTE-ACS, and this provided early management for them. We recommend that H-FABP assessment is better to be combined with cardiac Troponin assessment which is more specific, to confirm or exclude the diagnosis of NSTEMI. |