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Clinical significance of ischemia modified albumin for the early diagnosis of acute cardiac ischemia

Ding Aihua,Wang Shangwu (Department of Clinical Laboratory,Taojiang People′s Hospital,Yiyang,Hunan 413400,China)  
Objective To discuss the clinical significance of ischemia modified albumin (IMA) for the early diagnosis of acute cardiac ischemia(ACI).Methods Indirect albumin cobalt binding (ACB) test was performed to measure the serum IMA level and routine methods were performed for the detection of cardiac troponin T (cTnT) and creatine kinase isoenzyme MB (CK-MB) within 3 hours after the onset of thoracalgia in 80 cases of patients with definite diagnosis of acute coronary syndrome(ACS) and 60 patients with chest pain while finally diagnosed as non-ischemic heart diseases.By preparing receiver operating characteristic(ROC) curve,based on ACB value,the optimal cut-off value of IMA for the diagnosis of ACS was confirmed,and related sensitivity,specificity,positive predictive value and negative predictive value were calculated.Results Compared with control group,ACB value of ACS group was significantly lower,as (49.75±10.25)U/mL,with the statistically significant difference by t test(P0.01),while in ACS group,there was no significant difference in ACB values between acute myocardial infarction (AMI) group and unstable angina(UA) group (P0.05).In ACS group,serum levels of cTnT and CK-MB were (1.24±0.67)ng/mL and (35.14±9.37)U/L respectively,without statistical difference with control group by t test(P0.05).According to ROC curve,when cut-off value was 63.6 U/mL,the sensitivity,specificity,positive predictive value and negative predictive value of IMA for the diagnosis of ACS were relatively high,as 81.27%,86.58%,84.19% and 82.57% respectively.Conclusion IMA could be an sensitive marker for the early diagnosis of cardiac ischemia,with clinical significance for the early diagnosis and cure of ACS.
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