Serum 99th centile values for two heart-type fatty acid binding protein assays

Department of Clinical Biochemistry, Leeds General Infirmary, UK.
Annals of Clinical Biochemistry (Impact Factor: 2.34). 07/2009; 46(Pt 6):464-7. DOI: 10.1258/acb.2009.009055
Source: PubMed


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.

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Available from: Karthik Viswanathan, Dec 27, 2015
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    • "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 [13] and since such data in literature are scanty [14] [15] we defined our own 99th percentile upper reference limit for H-FABP in Italian subjects. "
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