Assay of ischemia‐modified albumin and C‐reactive protein for early diagnosis of acute coronary syndromes

Abstract

Diagnosis of cardiac ischemia in patients coming to emergency departments (ED) with symptoms of acute chest pain is often difficult. Many markers are sensitive and specific for the detection of myocardial necrosis but may not rise during reversible myocardial ischemia. Ischemia-modified albumin (IMA) has recently been shown to be a sensitive and early biochemical marker of ischemia. The variation laws were observed by measuring IMA and C-reactive protein (CRP) of 113 patients in ED within 12 hr after onset of chest pain. In the observation, blood was taken for IMA and CRP. Patients underwent standardized triage, diagnostic procedures, and treatment. Results of IMA and CRP were correlated with final diagnoses of nonischemic chest pain (NICP) and acute coronary syndrome (ACS). There were obvious distinction of IMA and CRP levels between the NICP and ACS groups. Receiver operator characteristic (ROC) curve analysis was used to determine the optimal cutoff of this assay for identifying individuals with ACS patients from NICP. The area under the curves of IMA is 0.948. The sensitivity and specificity of albumin cobalt binding (ACB) at a cutoff value of 70.0 units/mL were 94.4% and 82.6%, respectively. The area under the curves of CRP is 0.746. Sensitivity and specificity of CRP at a cutoff value of 3.16 mg/L were 70.0% and 73.9%, respectively. Negative predictive value (NPV) of IMA and CRP for ischemia origin was 79.2% and 38.6%, respectively. IMA may make an early diagnosis of acute coronary ischemia, and will improve the early diagnostic sensitivity and specificity of ACS.

Clinical Assessment of Ischemia‐modified Albumin and Heart Fatty Acid–binding Protein in the Early Diagnosis of Non‐ST‐elevation Acute Coronary Syndrome in the Emergency Department

“…In those studies, the patients were not ''all comers,'' and the prevalence of ACS was unusually high in contrast to the real-life situation in a big city ED. 25,30,[33][34][35] We included in our study patients who were more representative of the population admitted to the ED with chest pain. 36 Contrary to previous studies, we studied patients with episodes of chest pain (persistent or not) suggesting a diagnosis of ACS to the EP, evolving within 12 hours.…”

Ischemia-modified albumin and total antioxidant status in patients with slow coronary flow: a pilot observational study

“…Kazanis et al (13) found higher IMA levels in stable CADs compared to healthy controls and TAS was lower in the CAD group. Besides the role of serum IMA levels in atherosclerotic heart disease (36,37), this marker may be beneficial in determining of diagnosis and mortality in such circumstances as acute mesenteric ischemia, cerebrovascular accidents, endstage renal disease, cardiopulmonary resuscitation, and pulmonary embolism (33,(38)(39)(40)(41). Although serum IMA levels were similar between SCF and control groups, we found a negative correlation between serum IMA levels and TAS in patients with SCF.…”

Prognostic value of combination of heart‐type fatty acid‐binding protein and ischemia‐modified albumin in patients with acute coronary syndromes and normal troponin T values

“…Frozen samples were mixed thoroughly after thawing and recentrifuged before analysis. Serum IMA was measured by ACB test (20) on the Hitachi analyzer 7170. H-FABP was measured by immunochromatography assay (Kang Sheng Bao Bioscience Corporation, Shenzhen, China).…”