Background: Early identification of acute coronary syndrome
(ACS) is important. CK-MB and cardiac troponins show a delayed
rise approximately 3 to 6 hours after the onset of pain. Ischaemia
modified albumin (IMA) has been licensed through FDA for the early
diagnosis of myocardial ischaemia. This study aimed to assess the
role of IMA in the early diagnosis of ACS.
Methods: This study was conducted on 60 patients who were
admitted in the Cardiac Care Unit (CCU) of Benha University
Hospitals with acute chest pain less than 3 hours before admission.
All patients underwent serial IMA and cardiac troponin T (cTnT)
both at presentation and after 8 hours. Patients were divided into
two groups according to the discharge diagnosis: non-ischaemic
or ischaemic chest pain group. This classification based on
criteria of pain, ECG changes, and wall motion abnormalities by
echocardiography plus positive cTnT. Sensitivity, specificity,
positive (PPV) and negative predictive values (NPV) for both IMA
and cTnT were analyzed.
Results: Using 75 ng/dl as a cut off value for IMA and 0.04 ng/
dl for cTnT, the sensitivity and NPV of IMA to rule out ischaemia
was greater as compared to that of cTnT (70.6% & 63% vs 44.1%
& 42.2%). The combination between the IMA and the cTnT results
improved the sensitivity and NPV up to 85.3% at presentation and
up to 100% 8 hours after admission.
Conclusion: IMA is a useful marker for the early rule out of ACS.
Negative IMA (