ROLE OF ISCHEMIA MODIFIED ALBUMIN IN THE EARLY DIAGNOSIS OF ACUTE MYOCARDIAL INFARCTION.

Abstract

Abstract:

The primary aim of this study was to investigate serum Ischemia Modified Albumin (IMA) as a useful marker in the early diagnosis of Acute myocardial infarction (AMI). A total of 144 patients admitted in the Intensive care unit of PSG Hospitals with suspected AMI and 73 healthy control subjects were enrolled in this observational study. 24 patients were excluded. Serum cTnT was estimated by a fully automated Immunodiagnostics analyzer ROCHE Elecsys 2010. IMA was estimated by a spectrophotometric method as described byBar Or et al. The diagnostic sensitivity of the two markers were analysed using students ‘t’ test. Patients were divided into the AMI group (n = 104), the unstable angina group (n=10) and the non-ischemic chest pain group (n = 06), according to the ECG results.  Mean IMA values were higher in AMI group (p <0.00001) and in patients with Unstable Angina (UA) (p <0.005) compared with control. The diagnostic sensitivity of IMA was higher than cTnT in STEMI (100% vs 68%), NSTEMI ( 97% vs 44%) and in unstable angina(100% vs 0%) . In UA the cTnT levels remained below the cutoff level (<0.03 ng/mL). The increase in IMA levels was noted within minutes after the onset of symptoms and remained elevated after 6 hrs. The cTnT levels were below the cutoff levels in UA, whereas the IMA levels are elevated significantly (p <0.005) compared to controls.We have shown that IMA is a potential diagnostic biomarkerfor UA than cTnT and assessment of serum IMA in patients with chest pain will improve current diagnostic strategies foracute chest pain patients to avoid adverse cardiac events.