Estimation of Ischemia Modified Albumin (IMA) Levels in Patients with Acute Coronary Syndrome

Abstract

Myocardial ischemia produces free radicals that catalyze a series of oxidative reactions that damage healthy tissues. The N-terminal sequence of albumin is one of the proteins modified by these highly reactive oxygen species and forms the ischemia modified albumin (IMA). This study involves investigations undertaken in different study groups to assess the levels of IMA. Mean serum IMA levels (U/mL) in patients with ST-segment elevated myocardial infarction (92.1 ± 10.6), non-ST-segment elevated myocardial infarction (87.3 ± 5.95) and unstable angina (UA) (88.9 ± 6.16) were significantly higher than non-cardiac chest pain (77.9 ± 6.69) and also healthy subjects (54.7 ± 17.2) (p < 0.001). IMA is a highly sensitive marker and has a high predictive value, which might prove the usefulness of this biomarker for early detection of myocardial ischemia. These data indicate a possible role of the IMA test in the early triage of patients with chest pain.

Keywords: Acute coronary syndrome; Biomarker; Ischemia; Ischemia modified albumin; Reactive oxygen species.

Fig. 1

Receiver operator characteristic curve (ROC) of ischemia modified albumin (IMA). The area under the ROC = 0.933 (95 % confidence intervals (CI) 0.911–0.954). IMA cut-off point 84.4 U/mL; sensitivity 88 %; specificity 89 %