Added value of H-FABP as a plasma biomarker for the early evaluation of suspected acute coronary syndrome

Suspected acute coronary syndrome (ACS) represents a substantial healthcare problem and is responsible for a large proportion of emergency department admissions. Better triaging of patients with suspected ACS is needed to facilitate early initiation of appropriate therapy in patients with acute myocardial infarction (AMI) and to exclude low-risk patients who can safely be sent home, thereby limiting healthcare costs. H-FABP has been established as the earliest available plasma marker for myocardial injury. In this review we evaluate the clinical utility of H-FABP for suspected ACS. H-FABP shows added value in addition to cardiac troponin, especially in the early hours after onset of symptoms. Moreover, H-FABP identifies patients at increased risk for future cardiac events. It is concluded that measuring H-FABP along with troponin shortly after onset of symptoms improves risk stratification of patients suspected of having ACS in a cost-effective manner.