Abstract: Objective To investigate the clinical significance of ischemia modified albumin(IMA)in the early diagnosis of acute myocardial infarction(AMI). Methods A total of 126 patients with acute chest pain were enrolled. Through the final diagnosis, 67 cases were AMI(AMI group), while the other 59 cases were non-AMI (NAMI group). Their serum concentrations of IMA, cardiac troponin I(cTnI), myoglobin(MYO) and creatine kinase-MB(CK-MB) were determined respectively within or more than 6 h (7-24 h) after the onset of chest pain. A total of 50 healthy subjects without cardiac disorders were enrolled as control group. The sensitivity and diagnostic effectiveness of IMA in the early diagnosis of AMI were evaluated by receiver operating characteristic(ROC)curve. Results In AMI group, the serum levels of IMA, cTnI, MYO and CK-MB were higher than those in NAMI and control groups(P<0.001), and the serum levels in NAMI group were also higher than those in control group (P<0.001).The area under ROC curve(AUC)of IMA(<6 h) was 0.851[95% confidence interval (CI):0.775-0.926]. At the optimal cut-off of 82.1 U/mL, the sensitivity, specificity, positive predictive value and negative predictive value were 82.2%, 84.9%, 85.9% and 80.6%, respectively. The sensitivity of IMA was higher than that of cTnI(50.7%, P<0.001), MYO(67.1%, P<0.05)and CK-MB(20.9%, P<0.001).The positive detection rate for the combined determination of IMA, cTnI, MYO and CK-MB was 92.5% in the early diagnosis of AMI. Conclusions The determination of IMA among the suspected AMI patients has important significance in the early diagnosis of AMI. The combined determination of cardiac markers can improve the positive detection rate of AMI.

Key words: Ischemia modified albumin, Myoglobin, Cardiac troponin I, Creatine kinase-MB, Acute myocardial infarction