Ischemia-modified albumin in stable coronary atherosclerotic heart disease: clinical diagnosis and risk stratification.

OBJECTIVES

Ischemia-modified albumin (IMA), a new serum biomarker of myocardial ischemia, has been introduced in the diagnosis of acute coronary syndrome. However, few studies have been carried out in patients with stable coronary atherosclerotic heart disease (CHD). We aimed to evaluate the value of IMA in the diagnosis of stable CHD and to determine the correlation between IMA levels and the severity of myocardial ischemia.

METHODS

A total of 129 patients with diagnosed CHD who had signed an informed consent form were enrolled. Patients were willing to undergo coronary angiography, which was the gold standard for the diagnosis of CHD. IMA was detected by the albumin cobalt binding test before coronary angiography.

RESULTS

The mean IMA level of the non-CHD group was 67.68 ± 29.61 U/ml and that of the CHD group was 90.24 ± 29.61 U/ml. In the CHD group, the mean IMA levels of the one-branch lesion group, the two-branch lesion group, and the three-branch lesion group were 79.87 ± 18.37, 98.10 ± 23.39, and 98.06 ± 33.47 U/ml, respectively. IMA levels and the number of diseased coronary arteries were significantly correlated (P<0.01, r=0.299). When the cut-off threshold derived from the receiver operating characteristics curve was determined to be 93.07 U/ml, the sensitivity of admission IMA for a final diagnosis of CHD was 0.49, the specificity was 0.90, the negative predictive value was 0.45, and the positive predictive value was 0.91. Logistic regression analysis showed that IMA (P=0.000, b=2.056, odds ratio=7.815) was an independent predictor of CHD.

CONCLUSION

IMA showed a high specificity and predictive value in the diagnosis of CHD. In addition, IMA was a strong and independent predictor of CHD. IMA levels and the number of diseased coronary arteries were significantly correlated.