Study of Ischemia Modified Albumin as New Potential Diagnostic Biomarker In Acute Myocardial Infarction.

Background: Because of the varied presentation and associated high mortality the identification of patients with acute myocardial infarction is very critical for the patient management and has a bearing on the prognosis. Only about 22% patients admitted to cardiac care centers with chest pain having truly myocardial infarction. Aim: The goal of present study was to assess diagnostic value of serum ischemia modified albumin and compare it with sensitive cardiac troponin I and Creatine Kinase-MB in acute myocardial infarction. Methods: A diagnostic case control study was conducted on 102 patients presenting to the Emergency Department within 6 hrs of acute chest pain and 115 healthy age and sex matched volunteers formed the control group. Serum ischemia modified albumin level was estimated by albumin cobalt binding test using digital spectrophotometer, while troponin I was measured by immunofluroscence assay and creatine Kinase-MB was determined by immunoinhibition method.  The sensitivity and specificity of ischemia modified albumin, troponin I and creatine kinase-MB for detection of acute myocardial infarction were analyzed. The results of ischemia modified albumin, troponin I and creatine kinase-MB alone and in combination were correlated. Results: Ischemia modified albumin (p<0.05) and troponin I (p<0.001) concentrations were significantly higher in acute myocardial infarction than healthy controls. Sensitivity, specificity, positive predictive value and negative predictive value of ischemia modified albumin for detection of acute myocardial infarction was 88.24%, 93.91%, 92.78% and 90.00% compared to 86.27%, 93.04%, 91.67% and 88.43% respectively for the troponin I and 78.43%, 100%, 100%, and 83.94% for creatine kinase-MB. Combined use of ischemia modified albumin, troponin I, creatine kinase-MB significantly enhanced the sensitivity to 96%. The area under the receiver operating characteristic curve of ischemia modified albumin in acute myocardial infarction was 0.90. Conclusion: Ischemia modified albumin is a new potential diagnostic biomarker used together with other gold standard cardiac biomarkers can improve early diagnosis of acute myocardial infarction.