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Predictable values of the 1-hour algorithm for estimating the concentration of troponin using highly sensitive reagents are 98-100% for excluding myocardial infarction (MI) and 75-80% for identifying this pathology. Such algorithms are developed for the rapid confirmation or exclusion of myocardial infarction without ST-segment elevation and, when combined with clinical data and electrocardiogram, are used to assess the risk of adverse course of disease and to contribute to decision making about expediency of stay in the intensive therapy unit and early discharge.
In mid-1980s, a new marker of myocardial damage was proposed, namely: fatty-acid-binding protein (FABP). However, the diagnostic value of FABP cannot be interpreted unambiguously because of insufficient number of studies determining the sensitivity and specificity of the test in various manifestations of acute coronary syndrome (ACS).
Available literature presents a wide range of reference values of FABP for MI diagnosis. Reference value ranges are proposed by manufacturers of diagnostic kits based on previous studies. In addition, there is no information about the FABP changes during the first three hours of the disease, as well as there are no data on diagnostic value of changes in this indicator ("∆") in patients with ACS without ST-segment elevation. These considerations provide rationale and support novelty of the planned pilot study.
After enrollment in the study, patients will undergo the following procedures:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| FABP group | Other | Coronary angiography and PCI (according to indications). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| FABP | Diagnostic Test | Assessment of changes in FABP concentrations |
|
| Measure | Description | Time Frame |
|---|---|---|
| Fatty acid-binding protein (h-FABP) measure | Establishing diagnosis of NSTEMI based on h-FABP test for early detection of myocardial infarction | At 4 hours after suspected NSTEMI onset |
| Measure | Description | Time Frame |
|---|---|---|
| Troponin I (cTnI) measure | Establishing diagnosis of NSTEMI based on TnI test | At 4 hours after suspected NSTEMI onset |
| Creatine phosphokinase-MB (CPK-MB) measure | Establishing diagnosis of NSTEMI based on CPK-MB test |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Vyacheslav V. Ryabov, MD, PhD | Cardiology Research Institute, Tomsk NRMC | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cardiology Research Institute, Tomsk NRMC | Tomsk | 634012 | Russia |
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Single-center study
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| At 4 hours after suspected NSTEMI onset |
| Creatine phosphokinase (CPK) measure | Establishing diagnosis of NSTEMI based on CPK test | At 4 hours after suspected NSTEMI onset |