Meta-analysis of ischemia-modified albumin to rule out acute coronary syndromes in the emergency department

Peacock, W. Frank; Morris, Deborah L.; Anwaruddin, Saif; Christenson, Robert H.; Collinson, Paul; Goodacre, Steve; Januzzi, James L.; Jesse, Robert L.; Kaski, Juan Carlos; Kontos, Michael C.; Lefèvre, Guillaume; Mutrie, Dave; Sinha, Manas; Uettwiller-Geiger, Denise; Pollack, Charles V.

doi:10.1016/j.ahj.2005.12.024

Cited by 146 publications

(95 citation statements)

References 25 publications

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“…IMA measurement is recommended in the diagnosis of myocardial ischemia in patients with acute chest pain. One broad study determined that IMA had a high negative predictive value of 90% in excluding acute coronary syndrome in patients presenting to the emergency department with chest pain, and that the negative predictive value rose to 97.1% when evaluated together with negative cardiac troponins and nondiagnostic ECG results (12).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, IMA levels can rise in some conditions (end-stage kidney disease, certain neoplasms and liver diseases, and even in marathon runners) (9). A scan of the literature shows that elevated IMA levels have been reported in such acute ischemic conditions as cerebral ischemia, myocardial ischemia, mesenteric ischemia, muscular ischemia, and pulmonary ischemia, for which reason it has been thought that IMA can be used as a diagnostic marker (10)(11)(12).…”

Section: Discussionmentioning

confidence: 99%

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The diagnostic value of ischemia-modified albumin in the diagnosis of aortic pathology

Eroğlu¹,

Turkmen²,

Menteşe³

et al. 2014

Turk J Med Sci

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This study was designed to synthesize and evaluate derivatives of scopolamine (1) as acetylcholine esterase and protease inhibitors. Scopolamine (1) was extracted from the aerial parts of Datura innoxia through bioassay guided fractionation. Five different derivatives of scopolamine (1) were synthesized, and identified through spectroscopic studies. Their acetylcholine esterase (AChE) and trypsin inhibitory potentials were determined through standard protocols and evaluated from the perspective of structure-activity relationship.The synthesized scopolamine derivatives (2-6) showed remarkable AChE inhibitory activity, except for scopoline (6). The results showed higher enzyme inhibition potential of the synthesized compounds (2-5) as compared to scopolamine (1). Maximum inhibition was exhibited by scopolamine N -oxide (89.9 ± 1.2%, IC 50 = 37.4 ± 1.1 μ M)), followed by scopolamine sulfonic acid (70.3 ± 0.8%, IC 50 = 46.9 ± 1.0 μ M) and O -methyl scopolamine (66.1 ± 1.2%, IC 50 = 94.7 ± 0.8 μ M). All derivatives showed moderate activity against trypsin; maximum activity was exhibited by 6 (54.0 ± 1.4%) with IC 50 = 621.2 ± 3.7 μ M.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The diagnostic value of ischemia-modified albumin in the diagnosis of aortic pathology

Eroğlu¹,

Turkmen²,

Menteşe³

et al. 2014

Turk J Med Sci

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“…ACB assay has been used in previous studies [35][36][37]. Lee et al [38] developed a cobalt albumin binding assay to correct the flaws of the ACB test with improving the sensitivity and precision.…”

Section: Discussionmentioning

confidence: 99%

Ischemia-modified albumin as a marker of vascular dysfunction and subclinical atherosclerosis in β-thalassemia major

et al. 2017

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Background: Ischemia-modified albumin (IMA) is an altered type of serum albumin that forms under conditions of oxidative stress and an independent predictor of major adverse cardiovascular events. Objectives: To measure the levels of IMA in 45 children and adolescents with β-thalassemia major (β-TM) compared with 30 healthy controls and assess its relation to lipid peroxidation, vascular complications and subclinical atherosclerosis. Methods: β-TM patients without symptoms of heart disease were studied focusing on transfusion history, chelation therapy, serum ferritin, malondialdehyde (MDA) and IMA levels. Echocardiography was performed and carotid intima media thickness (CIMT) was assessed. Results: IMA and MDA levels were significantly higher in β-TM patients compared with controls (p < 0.001). IMA was higher among patients with heart disease, pulmonary hypertension risk and serum ferritin ≥2500 µg/l than those without. TM patients compliant to chelation had significantly lower IMA levels. IMA levels were positively correlated to MDA and CIMT while negatively correlated to ejection fraction and fractional shortening. Conclusion: Our results highlight the role of oxidative stress in the pathophysiology of vascular complications in thalassemia. IMA could be useful for screening of β-TM patients at risk of cardiopulmonary complications and atherosclerosis because its alteration occurs in early subclinical disease.

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“…People with higher IMA above 93.3U/ml showed higher short-term end points (20.4%Vs 9.6%) and higher 1-year mortality rate (11.7% vs 3.8%) that High ischemia modified albumin (IMA) was independent predictor of both of these outcomes. Meta-analysis done by Peacock et al 11 had also shown that triple negative prediction test of ischemia modified albumin (IMA), electrocardiogram and troponin measured within 3 hours of chest pain had not only have high negative predictive value for excluding acute coronary syndrome but also was cost-effective and did have better 30-day and 6-month outcomes.…”

Section: Methodsmentioning

confidence: 99%

Ischemic Modified Albumin (IMA) as a Novel Marker for Ischemic Heart Disease and Surrogate Marker for Other High Oxidative -Ischemic Conditions

Nepal¹,

Jaisawal²,

Guragain³

et al. 2017

JCDR

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Aims and Objectives: To find out if ischemia modified albumin can be a novel marker in ischemic heart disease. Materials and methods: Retrospective chart-review of chest pain patients who were evaluated in the emergency departments in 2006 and 2007. Results: Total of 400 patients presented with chest pain and subsequently were evaluated in the Emergency department at two major emergency departments associated with the teaching hospital associated Mercy Catholic Medical Center; few patients were excluded due to unavailability of complete data and follow-up visit in next six months. Thus, finally 351 patients met criteria for final analysis. Primary endpoints included the cardiac events and secondary outcomes were course in the hospital, days of hospitalization, interventions done in the hospital, disposition from the hospital, and readmission within next six months. Sensitivity and specificity of ischemia modified albumin (IMA) test was 80% and 50% respectively and positive predictive value and negative predictive values were 17% and 88% respectively. There were no further differences in cardiac events or interventions in higher ischemia modified albumin (IMA) group as compared to troponin (cTnT) (p=0.5). People with higher ischemia modified albumin (IMA) showed longer hospitalization days (p=0.025), needing nursing home or skilled nursing facility on discharge due to high discharge needs (p=0.0001) and had more readmissions as compared to troponin (p=0.02). However, Higher ischemia modified albumin (IMA) did not predict more cardiovascular events during hospital stay, rather troponin (cTnT) test predicted arrhythmia more than ischemia modified albumin (IMA) test (p=0.0001). Conclusion: Ischemia-modified albumin may be utilized as a novel marker of ischemia to rule out acute coronary syndrome along with troponin and electrocardiogram in the emergency departments. This test may also have short and long-term prognostic significances and may even be used as a surrogate marker in stroke, sepsis and thrombo-embolic diseases once these people need admission to the hospital.

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Meta-analysis of ischemia-modified albumin to rule out acute coronary syndromes in the emergency department

Cited by 146 publications

References 25 publications

The diagnostic value of ischemia-modified albumin in the diagnosis of aortic pathology

The diagnostic value of ischemia-modified albumin in the diagnosis of aortic pathology

Ischemia-modified albumin as a marker of vascular dysfunction and subclinical atherosclerosis in β-thalassemia major

Ischemic Modified Albumin (IMA) as a Novel Marker for Ischemic Heart Disease and Surrogate Marker for Other High Oxidative -Ischemic Conditions

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