Background: Heart-type fatty acid-binding protein (H-FABP) is a new biochemical marker which is recently being used in the early diagnosis of acute coronary syndrome (ACS) in the early phase at 0-3 hours of chest pain onset. The aim of this study was to diagnose ACS patients early in the ER using H-FABP in the early stage during 0-3 hours of chest pain. Methods: This is a cross-sectional descriptive study that included 41 ACS patients who presented to the emergency department of the Suez Canal University Hospital, who fulfilled the inclusion and exclusion criteria. Results: Out of the 41 patients of ACS, 26 were male and 15 were female with a mean age of 56.8 ± 12.9 years. It was found that H-FABP was elevated in 68.3% of the patients at 0-3 hours of chest pain which increased to 80.5% at 3-6 hours of chest pain onset with 76.2% sensitivity at 0-3 hours which increased to 85.7% at 3-6 hours, while specificity was 70% at 0-3 hours but increased at 3-6 hours. The receiver operating characteristic curve was performed to find out the best cut-off value of H-FABP at 0-3 hours and at 3-6 hours' interval which was 19 ng/l for diagnosis of acute MI (ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction). Conclusion: H-FABP is a promising cardiac biomarker for the early identification of myocardial ischemia and infarction. It could be a superior biomarker for earlier detection of ACS.

Keywords: Acute coronary syndrome, chest pain, heart-type fatty acid-binding protein, myocardial infarction.