Value of ischemia modified albumin (IMA) for diagnosis of acute coronary syndrome (ACS) in patients with acute chest pain

Ilija Dragojevic,B Kisic,M Miric,D Puhalo-Sladoje

doi:10.5937/pramed1404099d

Abstract

The aim of this study was to evaluate the diagnostic accuracy of ischemia modified albumin (IMA) alone, or in combination with cardiac troponin T (cTnT) and electrocardiogram (ECG) findings for diagnosis of acute coronary syndrome (ACS). The study included patients with acute chest pain suggestive on ACS, recruited within 6 hours from onset. Patients were classified in ACS group and non-ischemic chest pain group (NICP). Of 84 patients, 49 were diagnosed with ACS and 35 with NICP. IMA was significantly higher in ACS group (p<0.0001). The area under receiver operating curve for IMA in ACS diagnosis was 0.95 (p<0.0001). Sensitivity and specificity of IMA for ACS diagnosis were 89.8% and 91.4%, respectively. IMA significantly (p<0.05) improved the sensitivity of ECG and cTnT, alone, and in combination. Sensitivity and negative predictive value of combination of IMA, ECG and cTnT for diagnosis of ACS were 100%. IMA is useful for diagnosis of ACS, in combination with ECG and cTnT.

Highlights

The diagnosis of acute coronary syndrome (ACS) is currently based on evaluation of symptoms, electrocardiographic (ECG) findings and determination of markers of myocardial necrosis
ECG changes are present at admission in about 50% of patients with ACS, and widely used neither ECG findings nor determination of markers of myocardial necrosis can serve as a standard for the diagnosis of acute myocardial infarction (AMI)
In the unstable angina (UA) group, a clinical diagnosis was established in 4 cases while in 16 cases the diagnosis was based on objective testing

Summary

Introduction

The diagnosis of acute coronary syndrome (ACS) is currently based on evaluation of symptoms, electrocardiographic (ECG) findings and determination of markers of myocardial necrosis. ACS encompasses a wide spectrum of pathological conditions, ranging from unstable angina (UA) to transmural acute myocardial infarction (AMI). These are different clinical presentations of ACS they usually share a common pathophysiological substrate. Such marker could serve for initial identification of patients with ACS, followed by subsequent confirmation of the diagnosis of AMI versus UA using a sensitive and specific test for the presence of myocardial necrosis

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