Biomarker-Electrocardiography Synergy: Evaluating H-FABP and cTnI Serum Levels with ECG for Acute Myocardial Infarction Diagnosis

Acute myocardial infarction (AMI), a life-threatening cardiovascular emergency, necessitates prompt diagnosis to optimize therapeutic outcomes. This prospective cohort study evaluated the diagnostic efficacy of serum heart-type fatty acid-binding protein (H-FABP), cardiac troponin I (cTnI), and electrocardiography (ECG) in 240 patients presenting with chest pain (150 AMI, 90 non-AMI) alongside 240 healthy controls. Coronary angiography served as the diagnostic gold standard. Serum biomarkers were quantified using immunoturbidimetric (H-FABP) and chemiluminescent (cTnI) assays, while ECG abnormalities were assessed per standardized criteria.Key findings revealed significantly elevated H-FABP and cTnI levels in AMI patients compared to non-AMI and control groups (P < 0.05), with concentrations correlating positively with coronary lesion severity (Gensini score: moderate-severe vs. mild group, P < 0.05). ECG demonstrated 82.7% sensitivity but limited specificity (46.7%) for AMI detection. ROC analysis identified optimal diagnostic thresholds at 8.78 μg/L (H-FABP, AUC=0.781) and 0.65 ng/mL (cTnI, AUC=0.912), while combined biomarker-ECG assessment achieved superior diagnostic accuracy (AUC=0.966, 95% CI: 0.934–0.986), significantly outperforming individual modalities (P < 0.05). These results underscore the complementary role of H-FABP (providing early ischemic signals) and cTnI (confirming myocardial injury) in AMI diagnosis. Multimodal integration with ECG enhances diagnostic precision during the critical therapeutic window, facilitating timely intervention to mitigate infarct expansion. This strategy addresses the limitations of isolated ECG interpretation and delayed cTnI elevation, offering a clinically actionable approach for rapid AMI triage.