Does ischemia-modified albumin add prognostic value to the Thrombolysis In Myocardial Infarction risk score in patients with ST-segment elevation myocardial infarction treated with primary angioplasty?
BACKGROUND
The aim of the present study was to evaluate whether or not an elevated ischaemia-modified albumin (IMA) level provides any additional prognostic information to the validated Thrombolysis In Myocardial Infarction (TIMI) risk score in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI).


METHODS
One hundred seven consecutive STEMI patients treated with primary PCI were included. The incidence of 30-day death was the prespecified primary end point. Serum IMA was measured immediately at hospital arrival.


RESULTS
The incidence of the primary end point was 6.5%. A significant predictive value of IMA in relation to the primary end point was indicated by an area under the ROC curve of 0.71 (p = 0.01). In the multivariate analysis, increased IMA remained a significant predictor of the primary end point after adjustment for TIMI risk predictors (p = 0.019). The area under the ROC curve for the TIMI risk score was 0.68 (p = 0.03). The addition of IMA to the TIMI risk score did not improve its prognostic value (area under the ROC curve 0.60, p = 0.25).


CONCLUSIONS
IMA levels obtained at admission are a powerful indicator of short-term mortality in STEMI patients treated with primary PCI, but do not seem to be a marker that adds prognostic information to the validated STEMI TIMI risk score.
Dominguez-Rodriguez
Alberto
A
Department of Cardiology, University Hospital of Canarias, Tenerife, Spain. adrvdg@hotmail.com
Abreu-Gonzalez
Pedro
P
Jimenez-Sosa
Alejandro
A
Samimi-Fard
Sima
S
Idaira
Hernandez-Baldomero
HB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000378:metabolism*; D017130:Angioplasty; D004562:Electrocardiography; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D011379:Prognosis; D012372:ROC Curve
D000418:Albumins