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Review
. 2022 Jul 20;11(14):4205.
doi: 10.3390/jcm11144205.

Serum Concentrations of Ischaemia-Modified Albumin in Acute Coronary Syndrome: A Systematic Review and Meta-Analysis

Arduino A Mangoni  1   2 , Angelo Zinellu  3
Affiliations
Review

Serum Concentrations of Ischaemia-Modified Albumin in Acute Coronary Syndrome: A Systematic Review and Meta-Analysis

Arduino A Mangoni et al. J Clin Med. .

Abstract

The identification of novel circulating biomarkers of acute coronary syndrome (ACS) may improve diagnosis and management. We conducted a systematic review and meta-analysis of ischaemia-modified albumin (IMA), an emerging biomarker of ischaemia and oxidative stress, in ACS. We searched PubMed, Web of Science, and Scopus from inception to March 2022, and assessed the risk of bias and certainty of evidence with the Joanna Briggs Institute Critical Appraisal Checklist and GRADE, respectively. In 18 studies (1654 ACS patients and 1023 healthy controls), IMA concentrations were significantly higher in ACS (standard mean difference, SMD = 2.38, 95% CI 1.88 to 2.88; p < 0.001; low certainty of evidence). The effect size was not associated with pre-defined study or patient characteristics, barring the country where the study was conducted. There were no significant differences in effect size between acute myocardial infarction (MI) and unstable angina (UA), and between ST-elevation (STEMI) and non-ST-elevation MI (NSTEMI). However, the effect size was progressively larger in UA (SMD = 1.63), NSTEMI (SMD = 1.91), and STEMI (3.26). Our meta-analysis suggests that IMA might be useful to diagnose ACS. Further studies are warranted to compare the diagnostic performance of IMA vs. established markers, e.g., troponin, and to determine its potential utility in discriminating between UA, NSTEMI, and STEMI (PROSPERO registration number: CRD42021324603).

Keywords: ST-elevation myocardial infarction; acute coronary syndrome; acute myocardial infarction; biomarkers; ischaemia-modified albumin; non-ST-elevation myocardial infarction; unstable angina.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA 2020 flow diagram.
Figure 2
Figure 2
Forest plot of studies examining ischaemia-modified albumin in patients with acute coronary syndrome and controls.
Figure 3
Figure 3
Sensitivity analysis of the association between ischaemia-modified albumin and acute coronary syndrome. For each study, the effect size (hollow circles) corresponds to an overall effect derived from a meta-analysis excluding that study.
Figure 4
Figure 4
Funnel plot of studies investigating ischaemia-modified albumin concentrations in patients with acute coronary syndrome and controls.
Figure 5
Figure 5
Funnel plot of ischaemia-modified albumin concentrations in patients with acute coronary syndrome and controls after “trimming-and-filling”. Dummy studies and genuine studies are represented by enclosed circles and free circles, respectively.
Figure 6
Figure 6
Forest plot of studies examining ischaemia-modified albumin in patients with acute myocardial infarction or unstable angina vs. controls.
Figure 7
Figure 7
Forest plot of studies examining ischaemia-modified albumin in ST-elevation or non-ST-elevation myocardial infarction vs. controls.
Figure 8
Figure 8
Forest plot of studies examining ischaemia-modified albumin according to the country where the study was conducted.
See this image and copyright information in PMC

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