Assessment of Ischemic Modified Albumin levels as a Predictor Marker for Acute Coronary Syndrome

Abstract

Background: Acute coronary syndrome (ACS) is the clinical manifestation of the critical phase of coronary artery disease. Based on ECG and biochemical markers it is distinguished from ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina. The aim of this study was to Investigate the role of biochemical markers; Ischemia modified albumin (IMA) as an early diagnostic tool of ACS also, to Identify the cutoff values of these biochemical markers in early diagnosis of ACS. Methods: Case - control study approach was conducted on four groups of participants, MI- , MI+ , UA  and healthy Control  in  Kerbala and Baghdad  Governorates. All groups were exposed to medical examination for signs and symptoms of any cardiac disorders manifest such as Troponin with electrocardiographic patterns by specialized doctor. Serum biomarkers level were measured for the following parameter: IMA levels were measured using ELISA technique.; Measurement of Iipid profile levels in Human serum was performed using Spectrophotometric Technique; biochemical analyser for Complete blood count was done by XP-300™ Automated hematology analyzer Sysmex. The association between biochemical markers and disease severity was evaluated. The efficiency of the predicting value was assessed using receiver operating characteristic (ROC) curve. Results: Results were indicated that IMA levels were shown a significant increased range levels in the negative troponin MI cases compared to the positive troponin MI and unstable angina. The range levels were (3.12-6.41); (3.1-5.66) and (3.17-5.56) respectively. On the other hand, unstable angina cases were shown a decreasing level of Albumin and increasing levels of IMA/ Alb ratio. Results were also illustrated the receiver operating curve (ROC) and AUC analysis for the Ischemic Modified Albumin, IMA/Albumin ratio as possible diagnostic parameters.   IMA level was shown a good diagnostic performance for prediction ACS Patients compared to control group. the optimal diagnostic points for predicting ACS by IMA were (sensitivity = 90%, specificity = 80%) at a level = 3.59, while IMA/ Alb ratio levels: (sensitivity = 0.92%, specificity = 0.67%) at a level = 0.072.  Only p-values of the AUC for IMA were <0.001 and statistically significant. Conclusion: Serum IMA appears to be a sensitive biomarker of myocardial ischemia in MI patients. Data analysis confirmed the ability to detect ischemia before myocyte destruction. Also, results were indicated that assessment of concentrations