- Biomarker Discovery and Profiling
- Open Access
Unbound free fatty acid concentrations are increased in cardiac ischemia
Clinical Proteomicsvolume 1, pages41–44 (2004)
Monitoring increased plasma unbound free fatty acid (FFAu) concentrations has been proposed as a biomarker for myocardial ischemia. In the current study, 30 acute coronary syndrome (ACS) patients presenting in the emergency department, with chest pain within 12 h of onset, were clinically evaluated along with serial cardiac troponin I (cTnI) and FFAu measurements.
Increased FFAu were found in 28 of 30 (93%) of ACS patients, ranging from 2.0 to 430 nM. For the nine ACS patients with myocardial infarction (MI), FFAu levels were increased at presentation for all (100%). In contrast, cTnI was increased in only 9 of 30 (30%) patients, mean 0.7 μg/L, and in only 2 of 9 (22%) MI patients, mean 1.3 μg/L. During the 24 h following admission, cTnI increased in all 9 MI patients. FFAu concentrations increased in every sample in which cTnI increased.
Our findings suggest that FFAu is increased in ischemia regardless of the presence or absence of myocardial necrosis, as reflected by increased or normal cTnI, respectively.
Kurien VA, Oliver MF. Serum-free fatty acids after acute myocardial infarction and cerebral vascular occlusion. Lancet 1966;July 16:122–127.
Oliver MF, Opie LH. Effects of glucose and fatty acids on myocardial ischemia and arrhythmias. Lancet 1994;343:155–158.
Richieri GV, Ogata RT, Kleinfeld AM. A fluorescently labeled intestinal fatty acid binding protein; Interactions with fatty acids and its use in monitoring free fatty acids. J Biol Chem 1992;267:23495–23501.
Richieri GV, Ogata RT, Kleinfeld AM. The measurement of free fatty acid concentration with the fluorescent probe ADIFAB: a practical guide for the use of the ADIFAB probe. Mol Cell Biochem 1999;192:87–94.
Kleinfeld AM, Prothro D, Brown D, Davis RC, Richierie GV, DeMaria A. Increases in serum unbound free fatty acid concentrations following coronary angioplasty. Am J Cardiol 2004;78:1350–1354.
Myocardial infarction redefined—a consensus document of the Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. Eur Heart J 2000;21:1502–1513.
Falahati A, Sharky SW, Christenson D, McCoy M, Miller E, Murakami MM, Apple FS. Implementation of cardiac troponin I for detection of acute myocardial injury in an urban medical center. Am Heart J 1999;137:332–337; letter correction 1999;138:798–800.
Apple FS, Koplen B, Murakami MM. Preliminary evaluation of the Ortho ECi cardiac troponin I immunodiagnostic assay. Clin Chem 2000;46:572–574.
Apple FS, Wu AHB, Jaffe AS, European Society of Cardiology and American College of Cardiology guidelines for definition of myocardial infarction—how to use existing assay clinically and for clinical trials. Am Heart J 2002; 981–986.
Kleinfeld AM, Kleinfeld KJ, Adams JE. Serum levels of unbound free fatty acids reveal high sensitivity for early detection of acute myocardial infarction in patient samples from the TIMI II trial. JACC 2002;39:312A.
Adams JE, Kleinfeld A, Roe M, Yang H, Christenson RH, Ohman EM, Gibler WB, Measurement of levels of unbound free fatty acid allows the early identification of patients with acute coronary syndromes. Circulation 2002; Supplement:II-532.