Ischemia-modified albumin: is it a reliable diagnostic and prognostic marker for myocardial ischemia in real clinical practice?
OBJECTIVE
We investigated whether ischemia-modified albumin (IMA), a novel biomarker of acute myocardial ischemia, is reliable for diagnosing ischemic chest pain and predicting future cardiac events in clinical practice.


METHODS
We enrolled 390 patients (age 61.7 +/- 39.9 years) who arrived at the emergency department within 6 h of pain onset. We compared serum IMA levels of patients with ischemic chest pain (ICP) to those with nonischemic chest pain (NICP).


RESULTS
NICP was diagnosed in 162 patients and ICP in 205 patients. Median serum IMA levels did not differ between the NICP (99.0 U/ml; 95% confidence interval, 98.2-101.2 U/ml) and the ICP group (99.0 U/ml; 95% confidence interval, 99.4-102.6 U/ml; p = 0.320). During a 2-year follow-up, adverse cardiac events including cardiac death, myocardial infarction and recurrent angina occurred in 25 of 205 patients (12.2%) in the ICP group, but IMA was not predictive of cardiac events.


CONCLUSIONS
IMA was neither able to discriminate acute chest pain due to myocardial ischemia from that of other origin nor to predict cardiac events. Therefore, use of serum IMA levels for triage of patients with acute chest pain does not seem effective in clinical practice.
Kim
Jin-Sun
JS
Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University Health System, Seoul, Korea.
Hwang
Hye Jin
HJ
Ko
Young-Guk
YG
Kim
Jung-Sun
JS
Choi
Donghoon
D
Ha
Jong-Won
JW
Hong
Myeong-Ki
MK
Jang
Yangsoo
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism*; D002637:Chest Pain / Q000097:blood / Q000175:diagnosis / Q000401:mortality; D003329:Coronary Vasospasm / Q000097:blood / Q000175:diagnosis / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000175:diagnosis / Q000401:mortality; D011237:Predictive Value of Tests; D012709:Serum Albumin / Q000378:metabolism*
D015415:Biomarkers; D012709:Serum Albumin