Early Diagnosis of Acute Coronary Syndrome with Sensitive Troponin I and Ischemia Modified Albumin

MA  Takhshid; Javad  Kojuri; SMB  Tabei; AR  Tavasouli; S  Heidary; M  Tabandeh

International Cardiovascular Research Journal

The Official Annually Journal of Cardiovascular Research Center, Shiraz University of Medical Sciences

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Early Diagnosis of Acute Coronary Syndrome with Sensitive Troponin I and Ischemia Modified Albumin

Author(s):

MA Takhshid¹,

Javad Kojuri²,

SMB Tabei^3,*,

AR Tavasouli⁴,

S Heidary⁴,

M Tabandeh²

11Laboratory Sciences and Technology Research Center, Paramedical School, Shiraz University of Medical Sciences, Shiraz, Iran, Iran

2Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

3Genetic Department, Shiraz University of Medical Sciences, Shiraz, Iran

4Laboratory Sciences and Technology Research Center, Paramedical School,Shiraz University of Medical Sciences, Shiraz, Iran

International Cardiovascular Research Journal:Vol. 4, issue 4; e58472

Published online:Dec 01, 2010

Article type:Research Article

Received:Sep 20, 2017

Accepted:Dec 01, 2010

How to Cite:MA TakhshidJavad KojuriSMB TabeiAR TavasouliS HeidaryM Tabandehet al.Early Diagnosis of Acute Coronary Syndrome with Sensitive Troponin I and Ischemia Modified Albumin.Int Cardiovasc Res J.4(4):e58472.

Abstract

Background: In this study we compared the diagnostic performance of serum ischemia modified albumin (IMA) and sensitive cardiac troponin I (cTnI) assay for the detection of acute coronary syndrome (ACS) in patients presenting to the emergency department (ED) with acute chest pain.
Methods: A prospective study was conducted on 123 patients presenting to the ED within three hours of acute chest pain. A 12-lead ECG was recorded and IMA and cTnI were measured on arrival at the ED. After diagnostic testing, the patients were classified as either ACS (n=70) or non- ACS (n= 53). The results of IMA, ECG, and cTnI, alone and in combination, were correlated with final diagnoses.
Results: IMA showed higher sensitivity (84%) and negative predictive value (NPV, 88%) compared to cTnI (sensitivity 42%, NPV 66%) and ECG (sensitivity 58%, NPV 74%). Combined use of IMA, cTnI and ECG significantly improved the sensitivity (96%, P<0.05) and NPV (96%) of IMA. The diagnostic performance of IMA was similar in the case of non-ST-segment-elevation ACS (sensitivity 80%, NPV 80%). The sensitivity and specificity of IMA for diagnosis of acute myocardial infarction (AMI) were 88% and 48%, respectively.
Conclusion: Measuring IMA at the time of ED admission improves the early diagnosis of ACS and non-ST-segment-elevation ACS in patients with acute chest pain. However, the test is not an effective tool for diagnosis of AMI in patients with chest pain presenting to ED.

Keywords

Ischemia modified albumin

cardiac troponin

acute coronary syndrome

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