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Journal of The Korean Society of Emergency Medicine 2007;18(5): 375-380. |
| Clinical value of Ischemia Modified Albumin (IMA) and Albumin-Adjusted Ischemia Modified Albumin (Aa IMA) to the Patients with Suspected Acute Coronary Syndrome in Emergency Department |
| Young Shin Cho, Hoon Lim, Young Soon Cho, Ho Jung Kim, Hye Young Jang |
1Department of Emergency Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea. lovelydr@schbc.ac.kr
2Department of Emergency Medicine, Soonchunhyang University College of Medicine, Seoul, Korea. |
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| ABSTRACT |
PURPOSE:
To evaluation the Ischemia Modified Albumin (IMA) and Albumin-adjusted IMA (Aa IMA) as an early parameters for acute coronary syndrome.
METHODS:
Retrospective consecutive patients admitted with suspected Acute Coronary Syndrome (ACS) were a assessed with clinical history taking, electrocardiography (EKG), serial cardiac enzyme (creatine kinase, CK-MB, Troponin T), and percutaneous cardiovascular intervention (PCI). IMA and Aa IMA were calculated by receiver operating characteristics (ROC) curve analysis: sensitivity, specificity, negative predictive value, positive predictive value.
RESULTS:
A total of 396 patients (201 men, 195 women; median age 63.0 years) considered at acute coronary syndrome. The ACS was diagnosed in 114/396 (28.7%). Mean IMA level of ACS group was significantly higher than that of non-ACS group (100+/-15 U/mL vs 93+/-13 U/mL, p<0.05). ROC curve area estimated 0.64. If cut off value is 95.5, the sensitivity and specificity is calculated 62%, 62%. The negative predictive value (NPV) and positive predictive value is (PPV) 79% and 40% .The Aa IMA index was calculated [IMA index = serum albumin concentration (g/dL) x 23+IMA (U/mL)-100]. ROC curve area estimated 0.65 and the sensitivity and specificity was 74% and 50% at a cutoff value of Aa IMA index 90. The NPV and PPV is 82% and 37%.
CONCLUSION:
We concluded that IMA and Aa IMA are relative useful diagnostic tools as rule out ACS in Emergency Department because negative predictive value was high. |
| Key words:
Ischemia modified albumin (IMA), Albuminadjusted IMA (Aa IMA) |
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