Application of albumin-adjusted ischemia modified albumin index as an early screening marker for acute coronary syndrome

Existing cardiac markers are not sensitive for reversible myocardial ischemia. Ischemia modified albumin (IMA) has recently been shown to be an early and sensitive marker of myocardial ischemia. We established a newly standardized, albumin-adjusted IMA index that was more sensitive and accurate than...

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Bibliographic Details
Published in:Clinica chimica acta 2007-09, Vol.384 (1-2), p.24-27
Main Authors: Lee, Yong-Wha, Kim, Ho-Jung, Cho, Yoon-Haeng, Shin, Hee Bong, Choi, Tae-Youn, Lee, You Kyoung
Format: Article
Language:English
Subjects:
Acute coronary syndrome
Acute Disease
Albumin-adjusted IMA index
Biomarkers - blood
Coronary Disease - diagnosis
Early Diagnosis
Female
Humans
Ischemia modified albumin
Male
Myocardial Ischemia - diagnosis
Predictive Value of Tests
Sensitivity and Specificity
Serum Albumin - analysis
Syndrome
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Summary:Existing cardiac markers are not sensitive for reversible myocardial ischemia. Ischemia modified albumin (IMA) has recently been shown to be an early and sensitive marker of myocardial ischemia. We established a newly standardized, albumin-adjusted IMA index that was more sensitive and accurate than the conventional IMA value. We enrolled 413 consecutive patients with symptoms suggestive of acute coronary syndrome (ACS). All patients were classified to either the ACS group (n=129) or 4 other groups (n=284). The ideal cutoff value of IMA was calculated by the receiver operating characteristic (ROC) curve analysis. The albumin-adjusted IMA index was calculated from the results of correlation assay between serum albumin concentration and IMA value and re-applied. The sensitivity and specificity of IMA for ACS were 93.0% and 35.6%, respectively, at 85.0 U/ml. IMA had a negative linear relationship with serum albumin and albumin-adjusted IMA index was calculated by using the following equation [IMA index=serum albumin conc. (g/dl)×23+IMA (U/ml)−100]. The sensitivity and specificity were 98.4% and 34.5%, respectively, at IMA index of 83.4. The use of the calculated albumin-adjusted IMA index is recommended to increase the sensitivity of the ACS diagnosis although IMA is a sensitive marker for the identification of ACS.
ISSN:0009-8981
1873-3492
DOI:10.1016/j.cca.2007.05.003