title: Prognostic value of ischaemia-modified albumin in patients with non-ST-segment elevation acute coronary syndromes.
abstract: BACKGROUND
  Ischaemia-modified albumin (IMA) is a new sensitive diagnostic biochemical marker of myocardial ischaemia. The purpose of the study was to analyse the prognostic value of IMA in patients admitted for non-ST-segment elevation acute coronary syndromes (NSTE ACS).
  
  
  METHODS
  Consecutive patients admitted for NSTE ACS in our institution were prospectively included. IMA, cardiac troponin I (TnI) and C-reactive protein (CRP) were measured in all patients within 3h of last chest pain. The clinical combined endpoint was major adverse cardiac events (MACE) including cardiac death, nonfatal myocardial infarction (MI) and recurrent ischaemia leading to urgent revascularization. The independent prognostic impact of IMA on occurrence of the combined endpoint during hospitalization and at 1 year was tested by a logistic regression model and was systematically adjusted for other known clinical and biological predictors.
  
  
  RESULTS
  Seventy-nine patients were enrolled. Nine (11.4%) patients experienced the combined endpoint during hospitalization and 16 (20.2%) during 1-year follow-up. Median IMA level was significantly higher in patients with MACE during hospitalization (115 [93-126]U/mL versus 100 [42-138]U/mL; p=0.007) and at 1 year (114 [93-126]U/mL versus 97 [42-138]U/mL; p<0.001). After adjustment for conventional prognostic risk factors, IMA remained an independent predictor of MACE both during hospitalization (odds ratio [OR]: 1.08; 95% confidence interval [CI]: 1.01-1.16; p=0.03) and at 1 year (hazards ratio [HR]: 1.07; 95% CI: 1.03-1.12; p=0.003).
  
  
  CONCLUSIONS
  Baseline levels of IMA were associated with both short- and long-term cardiovascular (CV) events in patients admitted for NSTE ACS.
authors.affiliation: Department of Cardiology, CHU La-Timone, 264, rue Saint-Pierre, 13005 Marseille, France. laurent.bali@laposte.net
authors.forename: Laurent
authors.initials: L
authors.lastname: Bali
authors.forename: Thomas
authors.initials: T
authors.lastname: Cuisset
authors.forename: Roch
authors.initials: R
authors.lastname: Giorgi
authors.forename: Colette
authors.initials: C
authors.lastname: Monserrat
authors.forename: Jacques
authors.initials: J
authors.lastname: Quilici
authors.forename: Louis
authors.initials: L
authors.lastname: Carrega
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Mouret
authors.forename: Lyassine
authors.initials: L
authors.lastname: Nait-Saidi
authors.forename: Christopher
authors.initials: C
authors.lastname: Mielot
authors.forename: Marc
authors.initials: M
authors.lastname: Lambert
authors.forename: Régis
authors.initials: R
authors.lastname: Guieu
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Bonnet
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood*; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012709:Serum Albumin / Q000032:analysis*
chemical_list: D015415:Biomarkers; D012709:Serum Albumin; D002097:C-Reactive Protein