title: Ischaemia modified albumin in patients with acute coronary syndrome and negative cardiac troponin I.
abstract: BACKGROUND
  Approximately 40-60% of patients with acute coronary syndrome (ACS) have normal cardiac troponin I (cTnI) concentrations on admission. Ischaemia modified albumin (IMA) has been suggested as a new biomarker of myocardial ischaemia.
  
  
  METHODS
  A total of 43 patients presenting with symptoms suggestive of ACS but with normal (< 0.1 μg/L) cTnI concentrations and 45 healthy subjects were studied. The patients from the study group were divided into two groups: STEMI (n = 28) and NSTEMI (n = 15). All these patients were undergoing percutaneous coronary intervention (PCI) with stenting. The concentrations of cTnI, myoglobin and IMA were determined on admission and 4 h after PCI.
  
  
  RESULTS
  Mean (SD) IMA concentrations were higher in patients with ACS (114.39 ± 25.18 U/ml) as compared to the control group (96.24 ± 6.28 U/ml, p < 0.005). IMA concentrations ≥ 104.0 U/ml demonstrated 72.1% sensitivity and 75.6% specificity for the diagnosis of ACS. The area under the receiver operator characteristic curve was 0.766 (95% CI 0.664-0.868) for ACS patients (NSTEMI + STEMI). In both groups increased median (IQR) cTnI concentration after PCI was observed (STEMI patients to 65.4 (10.9-106.9) μg/L and NSTEMI to 17.6 (0.77-84.0) μg/L). In contrast, no increase in IMA concentration was observed.
  
  
  CONCLUSIONS
  IMA may be a useful biomarker for the identification of ACS patients presenting with typical acute chest pain and/or abnormal electrocardiograms but negative cTnI.
authors: Department of Biochemistry and Clinical Chemistry, Medical University of Warsaw, Warsaw, Poland.
authors: Grażyna
authors: G
authors: Sygitowicz
authors: Jadwiga
authors: J
authors: Janas
authors: Sławomir
authors: S
authors: Białek
authors: Jerzy
authors: J
authors: Pręgowski
authors: Lukasz
authors: L
authors: Pera
authors: Dariusz
authors: D
authors: Sitkiewicz
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000601:surgery; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000601:surgery; D009211:Myoglobin / Q000378:metabolism; D062645:Percutaneous Coronary Intervention; D012372:ROC Curve; D012709:Serum Albumin / Q000378:metabolism*; D019210:Troponin I / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D009211:Myoglobin; D012709:Serum Albumin; D019210:Troponin I