Diagnostic and prognostic performance of heart-type fatty acid–binding protein in functionally relevant coronary artery disease

Background This study aimed to evaluate the diagnostic and prognostic utility of heart-type fatty acid-binding protein (H-FABP) in patients with suspected functionally relevant coronary artery disease (fCAD).Methods The presence of fCAD was centrally adjudicated using myocardial perfusion imaging and coronary angiography. H-FABP high-sensitivity cardiac troponin T (hs-cTnT), and high-sensitivity cardiac troponin I (hs-cTnI) concentrations were measured at rest, peak stress, and 2 h after stress in a blinded fashion.Centrally adjudicated outcomes included all-cause death and cardiovascular death during 8-years.Results Among 2690 patients included in the diagnostic analysis (median age 68 years, 32% women), fCAD was present in 924 individuals (34%). Baseline H-FABP concentrations were higher in patients with fCAD than in those without (29 [23-38] vs 27 [22-35] ng/mL, p Conclusions H-FABP demonstrated limited diagnostic accuracy for detecting fCAD but is strongly and independently associated with long-term mortality.