Clinical utility of HFABP in myocardial infarction

Assessing chest pain patients presenting to the emergency area (EA) is still a clinical challenge, as acute myocardial infarction (AMI) diagnosis is not adjudicated in the majority of patients. New generation high sensitivity troponin assays (hs-cTn) still present some limitations, thus, novel biomarkers to early rule-in and rule- out myocardial infarction in chest pain patients presenting to the EA are sought after. Among all, heart- type fatty acid binding protein (h-FABP) has been largely investigated. Studies performed on HFABP in these patients present marked heterogeneity. However, it can be stated that HFABP is clearly not a reliable marker for AMI diagnosis, neither as a stand-alone test nor in combination with hs- cTn. More interventional trials are needed and more homogeneous studies are required to understand whether HFABP can add incremental value in rule- out AMI and risk stratify chest pain patients, however, available data may not encourage going on investigating.