title: Role of "Ischemia Modified Albumin" (IMA) in acute coronary syndromes.
abstract: BACKGROUND
  Diagnosis of acute coronary syndrome (ACS) is important, due to the associated very high mortality. Failure to diagnose ACS is a problem both for the patients and the clinicians. Ischemia modified albumin (IMA) has already been licensed by the US Food and Drug Administration for the diagnosis of suspected myocardial ischemia.
  
  
  METHODS
  Patients attending the emergency department (ED) within 6 h after having features of ACS were selected. IMA was done on admission. Blinded to the IMA results patients were fully evaluated and a diagnosis of non-ischemic chest pain (NICP), unstable angina (UA) or myocardial infarction (MI) was made. Later IMA results were correlated in each group.
  
  
  RESULTS
  Mean IMA value was 56.38 ± 23.89 u/ml in NICP group whereas in UA group it was 89.00 ± 7.76 u/ml and MI group was 87.50 ± 9.62 u/ml. This showed a sensitivity of 92% and specificity of 87%. The positive predictive value of the test was 88% and negative predictive value was 94%. In 16 patients an early diagnosis could be made when compared with Trop-T. Of the 89 patients 11 patients died in hospital. The IMA value was compared between this group and the patients who survived. Patients who died had a mean IMA value of 88.5 with a standard deviation of 5.33 whereas in patients who survived the mean value was 78.26 which was not statistically significant.
  
  
  CONCLUSIONS
  In conclusion the benefit of the test would be to rule out ACS in patients who present early to ED with inconclusive diagnosis.
authors: Associate Professor, Department of Cardiology, Narayana Medical College & Hospital, Nellore, Andhra Pradesh, India. Electronic address: bhakthadm@yahoo.co.in.
authors: C
authors: C
authors: Bhakthavatsala Reddy
authors: Assistant Professor, Department of Cardiology, Narayana Medical College & Hospital, Nellore, Andhra Pradesh, India.
authors: Cijo
authors: C
authors: Cyriac
authors: DM Cardiology PG, Narayana Medical College & Hospital, Nellore, Andhra Pradesh, India.
authors: Hrishikesh B
authors: HB
authors: Desle
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood*; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D004452:Echocardiography; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012709:Serum Albumin / Q000378:metabolism*; D020107:Troponin T / Q000097:blood
chemical_list: D015415:Biomarkers; D012709:Serum Albumin; D020107:Troponin T
keywords: Acute coronary syndrome; Ischemia modified albumin; Trop T
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