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; SMB  Tabei

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

MA Takhshid ¹ , Javad Kojuri ² , SMB Tabei ^{3
, *} , AR Tavasouli ⁴ , S Heidary ⁴ and M Tabandeh ²

Authors Information

¹ 1Laboratory Sciences and Technology Research Center, Paramedical School, Shiraz University of Medical Sciences, Shiraz, Iran, Iran

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

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

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

Article information

International Cardiovascular Research Journal: December 31, 2010, 4 (4); e58472
Published Online: December 01, 2010
Article Type: Research Article
Received: September 20, 2017
Accepted: December 01, 2010

To Cite: Takhshid M , Kojuri J , Tabei S , Tavasouli A , Heidary S , et al. Early Diagnosis of Acute Coronary Syndrome with Sensitive Troponin I and Ischemia Modified Albumin, Int Cardio Res J. 2010 ; 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.