Value of ischemia modified albumin in elderly patients with acute coronary syndrome

Abstract

Objective To investigate the diagnostic value of ischemia-modified albumin(IMA) in elderly patients with acute coronary syndrome(ACS). Methods Data of 153 elderly patients suspected for ACS were collected as case group. Blood sample was obtained for the measurement of IMA, CK-MB and cTnT in all patients at emergency department and 12 hours (12 h) later. Routine check of the 18-lead electrocardiogram (ECG), echocardiography, chest X-ray, abdominal ultrasound, coronary angiography was performed in all cases. Eighty healthy people were selected as the control group. The sensitivity and specificity of IMA, cTnT, ECG and the combination of the three indicators for early diagnosis of ischemia in elderly patients with ACS were separately evaluated. The value of IMA in stratification of elderly patients with ACS was also evaluated. Results Of the 153 cases, 95 were diagnosed ACS [including 36 cases with acute ST elevation myocardial infarction (STEMI), 48 with acute non-ST elevation acute myocardial infarction (NSTEMI) and 11 with unstable angina (UA)], and 86 were found cTnT positive at 12 h. The sensitivity of IMA for cTnT positive at 12 h and the diagnosis of ACS were [95.3% (82/86) and 96.8% (92/95), respectively], and negative predictive value were [92.7% (51/55) and 94.5% (52/55), respectively]. The sensitivities and negative predictive values of cTnT [26.7% (23/86), 25.3% (24/95) and 50.8% (65/128), 44.5% (57/128)] and ECG [40.7% (35/86), 41.1% (39/95) and 52.3% (56/107), 47.7% (51/107)] at admission were poor. The sensitivity of combination of the three indicators were [98.8% (85/86) and 97.9% (93/95), respectively] and negative predictive value were [98.1% (50/51) and 96.1% (49/51), respectively]. IMA in ACS group was significantly higher than in non-ACS group (P<0.05). Conclusions IMA can be used to the early diagnosis and risk stratification in elderly patients with ACS. Key words: Aged; Acute coronary syndrome; Ischemia-modified albumin