02 Dec 2022
30 Nov 2022
Early diagnosis of acute coronary syndrome (ACS) is crucial, owing to the high mortality rate associated with it. Failure in diagnosis of ACS is a concern for both the patients and the clinicians. Ischemia modified albumin (IMA) has been proposed as a useful marker for the diagnosis of acute coronary syndrome (ACS) in the emergency department (ED). This study assessed the utility of IMA in early diagnosis of ACS in patients with acute chest pain, and evaluated its diagnostic performance compared to creatine kinase-MB (CK-MB) and electrocardiogram (ECG). The study included 127 patients presenting to the ED within three hours of acute chest pain. Depending on the final diagnosis, patients were classified into acute myocardial infarction group (n=45), unstable angina group (n=52) and non-ischemic chest pain group (NICP) (n=30). Ischemia modified albumin value was significantly higher in ACS patients compared to NICP. According to ROC curve, the optimal cutoff of IMA was 71.3 u/ml, which had a sensitivity and specificity of 86.5% and 76.7% respectively. The sensitivity of IMA assay (86.5%) was significantly higher compared to ECG (54.6%), and CK-MB (11.3%). IMA used together with CK-MB or ECG, increased their own sensitivity to reach 88.7% and 90.7% respectively. All three tests combined identified 95.9% of patients whose chest pain was attributable to ACS. Our findings revealed that IMA is a sensitive marker for early detection of ACS in patients presenting with symptoms of acute chest pain.