Diagnostic Performance of H-FABP Versus Conventional Biomarkers and ECG in Early Detection of Acute Myocardial Infarction: A Prospective Analysis

AbstractBackground: Early diagnosis of acute myocardial infarction (AMI) is critical. Heart-typefatty acid-binding protein (H-FABP) rises earlier than conventional markers. This studyanalyses a patient-level dataset of 65 consecutive patients presenting within 4 hours ofchest pain to evaluate H-FABP, cTnI, CK-MB and ECG for early AMIdiagnosis.Methods: Patient-level data (n=65; AMI=23, non-AMI=42) includingdemographics, risk factors, onset time and point-of-care biomarker results were analyzed.Sensitivity, specificity, PPV, NPV, accuracy and AUC with 95% CIs were calculated.Paired comparisons used McNemar's test.Results: H-FABP demonstrated the highestdiagnostic sensitivity (91.3%, 95% CI: 81.2–98.4) and specificity (88.1%, 95% CI: 78.5–95.2) compared to cTnI (65.2%, 95% CI: 52.1–76.5), CK-MB (60.8%, 95% CI: 49.4– 72.1), and ECG (56.5%, 95% CI: 44.1–68.4). The overall diagnostic accuracy of H-FABP was 89.2% versus 72.3% for cTnI, 68.4% for CK-MB, and 63.1% for ECG (p < 0.001). Conclusion: H-FABP showed superior early diagnostic performance in thispatient-level dataset and may be a useful point-of-care adjunct.