We have previously demonstrated that heart-type fatty acid binding protein (H-FABP) is an independent prognostic marker for survival after acute coronary syndrome (ACS). This study aimed to define the 99th centile values for H-FABP as determined with two different assays, and to study the relationship with age, gender and renal function.
H-FABP was measured on redundant routine outpatient samples using the MARKIT-M (Dainippon) and the Evidence Investigator (Randox) assays.
Two hundred and forty-two subjects with Siemens Ultra-TnI value <0.045 microg/L (99th centile) were studied. In all, 174 subjects had estimated glomerular filtration rate (eGFR) >60 mL/min. The 99th centile values for subjects with eGFR >60 mL/min for the Evidence Investigator H-FABP were 5.3 and 5.8 microg/L and for the MARKIT-M H-FABP were 8.3 and 9.1 microg/L in female and male subjects, respectively. There is an increase in H-FABP with age in subjects with normal renal function for both assays. Gender comparison showed no significant difference for either assay. Comparison of samples showed that subjects with eGFR <60 mL/min showed a median increase of 0.71 microg/L with Evidence Investigator assay and 1.09 microg/L with MARKIT-M assay compared with subjects with eGFR >60 mL/min. Calibration differences were confirmed by cross measurement of calibrators and recombinant H-FABP.
We have defined the 99th centile values for H-FABP in a population of primary and secondary care outpatients that can be used to risk stratify patients with ACS. We have confirmed that H-FABP increases with renal dysfunction and age, but have not confirmed the gender difference previously reported.
"Furthermore, we wanted to evaluate stability of the protein at room temperature and cool storage, in order to exclude variation in H-FABP concentration affecting the accuracy of results. Finally, as reference intervals are the most common decision support tool for interpretation of laboratory results  and since such data in literature are scanty   we defined our own 99th percentile upper reference limit for H-FABP in Italian subjects. "
[Show abstract][Hide abstract] ABSTRACT: Background:
Heart-type fatty acid-binding protein (H-FABP) is an early biomarker of cardiac injury. Randox Laboratories developed an immunoturbidimetric H-FABP assay for non-proprietary automated clinical chemistry analysers that could be useful in the emergency department. We verified the analytical performances claimed by Randox Laboratories on Roche Cobas 6000 clinical chemistry platform in use in our laboratory, and we defined our own 99th percentile upper reference limit for H-FABP.
For the verification of method performances, we used pools of spared patient samples from routine and two levels of quality control material, while samples for the reference value study were collected from 545 blood donors. Following CLSI guidelines we verified limit of blank (LOB), limit of detection (LOD), limit of quantitation (LOQ), repeatability and within-laboratory precision, trueness, linearity, and the stability of H-FABP in EDTA over 24h.
Results and discussion:
The LOQ (3.19 μg/L) was verified with a CV% of 10.4. The precision was verified for the low (mean 5.88 μg/L, CV=6.7%), the medium (mean 45.28 μg/L, CV=3.0%), and the high concentration (mean 88.81 μg/L, CV=4.0%). The trueness was verified as well as the linearity over the indicated measurement interval of 0.747-120 μg/L. The H-FABP in EDTA samples is stable throughout 24h both at room temperature and at 4 °C. The H-FABP 99th percentile upper reference limit for all subjects (3.60 μg/L, 95% CI 3.51-3.77) is more appropriate than gender-specific ones that are not statistically different.
[Show abstract][Hide abstract] ABSTRACT: During the past few years, the air transportation industry and the Federal Aviation Administration (FAA) have identified a number of optional operational strategies intended to save jet fuel. Currently, a number of these options are either fully or partially implemented. However, the implementation is generally based on relatively simple open-loop control approaches, and the application of more sophisticated real-time decision and closed-loop control techniques could offer additional fuel savings. In light of the escalating price of jet fuel, a careful reexamination of the cost/ benefits of operational strategies involving the application of real-time decision and control technology is considered to be mandatory. This paper examines 12 fuel conservation strategies applicable to commercial aviation operations and considered to be candidates for the application of real-time decision and control techniques. The information presented is based on a comprehensive review of the literature and on discussions with personnel associated with the fuel conservation efforts of airlines, aircraft manufacturers, research organizations, airline employee organizations, and government agencies. The total fuel savings potential of these strategies is estimated to be about 12 percent of current fuel usage. Savings already achieved through the partial implementation of these 12 strategies and other strategies, described in Reference 1, are shown to be about 5 percent. However, realization of the remaining savings potential will depend on the application of near-optimal, real-time decision and control techniques. Of the operational strategy categories identified and analyzed in Reference 1, the Improved Airline Flight Procedures, Improved Air Traffic Control (ATC) Procedures, and Improved Equipment Related Procedures are most amenable to the application of real-time decision and control techniques and are briefly described in the following paragraphs.
Decision and Control including the Symposium on Adaptive Processes, 1979 18th IEEE Conference on; 01/1980
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