| Objective: To investigate the role of ischemia modified albumin (IMA) in the early diagnosis of acute coronary syndrome (ACS) and evaluate the correlations between IMA level and cardiac function, coronary lesion type, degree and position. Methods: IMA, troponin I (cTnI), N-terminal pro-B-type natriuretic peptide (NT-proBNP), electrocardiogram (ECG) and left ventricular ejection function (LVEF) were immediately measured after admission in 65 patients with ACS (ACS group) who were admitted within 6h after onset and 50 patients (control group) with negative coronary angiogram (CAG). And the results were followed up if necessary. All the patients underwent coronary angiography and the degree of the coronary lesion was evaluated by Gensini score.Results: The optimal cut-off value of IMA for the detection of ACS is 60.5U/mL; and its sensitivity, specificity, positive predictive value and negative predictive value were 89.23%, 72.00%, 80.56% and 83.72% respectively. In ACS group, IMA level in patients with acute myocardial infarction (AMI) or unstable angina pectoris (UAP) were (53.88±5.11)U/mL or (57.85±4.27)U/mL respectively; each was lower than that in the control group [(63.73±6.36)U/mL, both P<0.01]. Moreover, AMI patients had lower IMA levels than UAP patients (P<0.01). No significant correlations were detected between IMA level and pro-BNP, LVEF, coronary lesion degree or site, and Gensini score, respectively. The sensitivity for IMA, cTnI, ECG, IMA+cTnI, IMA+ECG, cTnI+ECG and IMA+cTnI+ECG for the detection of ACS were 89.23%, 72.31%, 81.54%, 95.38%, 92.31%, 86.15% and 96.92% respectively. The Pearson correlation coefficient for IMA and cTnI was-0.366 (P<0.01).Conclusions: IMA is effective in the early diagnosis of ACS and assessment of myocardial ischemia. Nevertheless, IMA can not be applied for evaluating coronary lesion degree, site or cardiac function. Combinations of IMA and other myocardial damage markers increase the sensitivity for the early detection of ACS. |
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