The Usefulness of Heart-type Fatty Acid binding Protein and Ischemia Modified Albumin to Diagnose the Cardiac cause of Arrest and the Difference of the Two Biomarkers between the Return of Spontaneous Circulation (ROSC) group and the non-ROSC group

ABSTRACT

PURPOSE: The purpose of this study was to investigate the usefulness of heart-type fatty acid binding protein (H-FABP) and ischemia modified albumin (IMA) to differentiate the causes of cardiac arrest. METHODS: From May 2007 to November 2007, we prospectively studied 27 patients who presented to the emergency department with sudden collapse. The blood samples collected during cardiopulmonary resuscitation (CPR) were centrifuged at 3000 rpm for 10 min, and the obtained serum was stored at -70degrees C. RESULTS: Cardiac arrest were caused by cardiac disease (N=7, 26%), trauma (N=7, 26%) and other disease (N=13, 48%). The patients with cardiac cause showed significantly increased H-FABP levels compared to the patients with noncardiac causes (39.7+/-19.3 ng/mL vs 24.6+/-16.9 ng/mL, respectively, p=0.048). The cut-off value of H-FABP was 29.05 ng/mL (sensitivity 85%, specificity 75%). The IMA showed no statistical difference between the patients with cardiac causes and those with non-cardiac causes (86.6+/-29.9 U/mL vs 107.4+/-39.4 U/mL, respectively, p=0.219). There were no significant differences of the H-FABP and IMA levels between the return of spontaneous circulation (ROSC) group and the non-ROSC group, and also between the survival and death groups. A higher H-FABP concentration was correlated with a longer arrest time, and mortality was correlated with a longer CPR time. CONCLUSION: The IMA is not changed according the cause of arrest, but the H-FABP is useful to diagnose the cardiac causes of arrest.