title: Ischemia-modified albumin measured with ultra-filtration assay in early diagnosis of acute coronary syndrome.
abstract: BACKGROUND
  Patients with acute chest pain remain a great diagnostic challenge to emergency physicians. Ischemia-modified albumin (IMA) is a recently developed biomarker of transient myocardial ischemia. IMA has already been licensed by the US Food and Drug Administration for diagnosis of suspected myocardial ischemia. This study aimed to assess the diagnostic value of IMA in treatment of patients with acute coronary syndrome(ACS).
  
  
  METHODS
  IMA level was detected by ultra-filtration assay combined with albumin-cobalt binding (ACB) test as well as tests of myoglobin (MYO), creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) in 169 consecutive patients with acute chest pain onset within 24 hours. Receiver operating characteristic (ROC) curve for IMA in diagnosing ACS was established to determine the cut-off point. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of IMA and its combinations with other agents were analyzed.
  
  
  RESULTS
  Area under the ROC curve (AUC) was 0.754. As the cut-off point for IMA in this study was 70.4 U/ml, the sensitivity, specificity, PPV and NPV of IMA were 79.8%, 65.2%±77.7%, and 69.7%, respectively. The sensitivity and NPV of IMA combined with the conventional cardiac marker panel for the diagnosis of ACS were 93.4% and 86.0%, respectively.
  
  
  CONCLUSIONS
  IMA is a useful biochemical marker for the early diagnosis of ACS. IMA combined with the conventional cardiac marker panel can improve early diagnosis of ACS compared with the traditional combinations of myocardial biochemical markers.
authors.affiliation: Emergency Center, Xinhua Hospital, Shanghai Jiaotong University, Shanghai 200092, China (Pan SM, Lin Q, Zhao J); Emergency Department, Zhongshan Hospital,Fudan University,Shanghai 200032,China (Tong CY, Yao CL, Deng Z).
authors.forename: Shu-Ming
authors.initials: SM
authors.lastname: Pan
authors.affiliation: Emergency Center, Xinhua Hospital, Shanghai Jiaotong University, Shanghai 200092, China (Pan SM, Lin Q, Zhao J); Emergency Department, Zhongshan Hospital,Fudan University,Shanghai 200032,China (Tong CY, Yao CL, Deng Z).
authors.forename: Chao-Yang
authors.initials: CY
authors.lastname: Tong
authors.affiliation: Emergency Center, Xinhua Hospital, Shanghai Jiaotong University, Shanghai 200092, China (Pan SM, Lin Q, Zhao J); Emergency Department, Zhongshan Hospital,Fudan University,Shanghai 200032,China (Tong CY, Yao CL, Deng Z).
authors.forename: Qing
authors.initials: Q
authors.lastname: Lin
authors.affiliation: Emergency Center, Xinhua Hospital, Shanghai Jiaotong University, Shanghai 200092, China (Pan SM, Lin Q, Zhao J); Emergency Department, Zhongshan Hospital,Fudan University,Shanghai 200032,China (Tong CY, Yao CL, Deng Z).
authors.forename: Chen-Ling
authors.initials: CL
authors.lastname: Yao
authors.affiliation: Emergency Center, Xinhua Hospital, Shanghai Jiaotong University, Shanghai 200092, China (Pan SM, Lin Q, Zhao J); Emergency Department, Zhongshan Hospital,Fudan University,Shanghai 200032,China (Tong CY, Yao CL, Deng Z).
authors.forename: Jie
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Emergency Center, Xinhua Hospital, Shanghai Jiaotong University, Shanghai 200092, China (Pan SM, Lin Q, Zhao J); Emergency Department, Zhongshan Hospital,Fudan University,Shanghai 200032,China (Tong CY, Yao CL, Deng Z).
authors.forename: Zhi
authors.initials: Z
authors.lastname: Deng
keywords: Acute coronary syndrome; Ischemia-modified albumin