The Clinical Assessment of Ischaemia Modified Albumin and Troponin I in the Early Diagnosis of the Acute Coronary Syndrome
Background: An early identification of the patients with the Acute Coronary Syndrome (ACS) is of prime importance, due to the associated very high mortality. Only about 22% of the patients who present at the emergency cardiology care centres with chest pain, have coronary disease. Ischaemia modi...
Main Authors: | , , , , , , |
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Format: | Article |
Language: | English |
Published: |
JCDR Research and Publications Private Limited
2013-05-01
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Series: | Journal of Clinical and Diagnostic Research |
Subjects: | |
Online Access: | https://jcdr.net/articles/PDF/2944/5-%205288_PF1(M)_E(C)_F(T)_PF1(M)_PF1(T)_FA(T)_PF1(PP)_PF2(PP).pdf |
Summary: | Background: An early identification of the patients with the Acute
Coronary Syndrome (ACS) is of prime importance, due to the
associated very high mortality. Only about 22% of the patients
who present at the emergency cardiology care centres with chest
pain, have coronary disease. Ischaemia modified albumin has
already been licensed by the US Food and Drug Administration
for the diagnosis of suspected myocardial ischaemia.
Aim: The goal of the present study was to assess the diagnostic
value of serum ischaemia modified albumin and to compare
it with sensitive cardiac troponin I in patients with the acute
coronary syndromes like unstable angina and acute myocardial
infarction.
Methods: A diagnostic case control study was conducted on
102 patients who presented to the Emergency Department
within 6 hrs of having acute chest pain and on 110 healthy age
and sex matched volunteers who formed the control group. The
serum Ischaemia Modified Albumin level was estimated by the
albumin cobalt binding test by using a digital spectrophotometer,
while Troponin I was measured by doing an immunofluroscence
assay. A receiver operating characteristic curve was established
for ischaemia modified albumin, to determine the cut-off point.
The sensitivity and the specificity of ischaemia modified albumin
and troponin I for the detection of acute coronary syndromes,
were analyzed. The results of ischaemia modified albumin and
troponin I alone and in combination, were correlated.
Results: The ischaemia modified albumin (p<0.05) and the
troponin I (p<0.001) concentrations were significantly higher in
acute myocardial infarction and in unstable angina than in the
healthy controls. The sensitivity and the specificity of ischaemia
modified albumin for the detection of acute coronary syndromes
was 88% and 93% as compared to 87% and 75% respectively
for troponin I. The combined use of ischaemia modified albumin
and troponin I significantly enhanced the sensitivity to 96%. The
area which was under the Receiver Operating Characteristic
(ROC) curve of ischaemia modified albumin in acute coronary
syndromes was 0.90.
Conclusion: Ischaemia modified albumin is a useful biochemical
marker for the early diagnosis of acute coronary syndrome.
The combined use of ischaemia modified albumin and cardiac
troponin I enhances the sensitivity and specificity. Hence, a
combination of ischaemia modified albumin and cardiac troponin
I can be used as a more precise diagnostic marker for Acute
Coronary Syndrome. |
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ISSN: | 2249-782X 0973-709X |