Role Of "Ischemia Modified Albumin" In The Diagnosis Of Acute Ischemia Chest Pain

Objective: To evaluate the role of ischemia modified albumin (IMA)in the early diagnosis of acute ischemia chest pain (ICP). Methods: A12-1cad ECG was recorded and blood was taken for IMA, cardiactroponin I(cTnI), and creatine kinase MB (CK-MB) at presentation in206 patients within 12 hours of acute chest pain. Results of IMA, ECG,cTnI, and CK-MB alone and in combination, were correlated with finaldiagnosis of non-ischaemic chest pain (NICP) and ICE Results: 98patients were discharged with a final diagnosis of ICP and 108 patientswith NICP. IMA levels were significantly higher in ICP within 3 hoursand between 3 and 6 hours compared with NICP (P＜0.001), but there wasno difference between ICP beyond 6 hours and NICP (P＞0.05).Sensitivity and negative predictive value (NPV) of IMA for ICP within 3hours was 89.1% and 88.8%, compared with 47.8% and 46.8% of ECG,10.8% and 47.4% of cTnI, and 6.5% and 46.8% of CK-MB; all four testscombined identified 97.6% of ICE Sensitivity and NPV of IMA for ICPbetween 3 and 6 hours was 71.7% and 74.5%, compared with 53.4% and62.8% of ECG, 17.6% and 50.0% of cTnI, and 11.1% and 48.0% ofCK-MB; all four tests combined identified 95.5% of ICE But IMA wasnot able to identify ICP beyond 6 hours. Conclusions: IMA is a sensitivebiochemical marker in the early diagnosis of ICE Compared with ECG, CK-MB, and cTnI, the sensitivity of IMA is higher in ICP within 6 hours(especially within 3hours). IMA used together with other tests has astronger role in the diagnosis of ICP. IMA is able to identify and rule outICP early.