Role of ischemia modified albumin to ST-segment resolution after mechanical reperfusion in patients with ST-segment elevation myocardial infarction

ObjectiveTo investigate the possible association between admission ischemia modified albumin (IMA) levels and ST-segment resolution (STR) in ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI).Materials and MethodsWe studied 117 patients with a first STEMI within 6 h of the onset of pain. Admission serum IMA concentration was measured using a validated assay. The worst single electrocardiogram lead before and 90 min after primary PCI was analyzed, and patients were divided into two groups according to the degree of STR: complete (≥70%) or incomplete (<70%).ResultsOf the 117 patients, 70 (60%) had complete STR, and 47 (40%) incomplete STR. Serum IMA concentrations were significantly higher in patients that had incomplete STR (0.383 ± 0.060 A.U. vs. 0.297 ± 0.056 A.U., p < 0.001). IMA levels >0.325 A.U. demonstrated a sensitivity of 91.4% and a specificity of 45.7% for the diagnosis of incomplete STR; the area under the receiver operator characteristic curve was 0.849 (95% CI 0.77–0.92, p = 0.0001). Moreover, IMA values were an independent predictor of incomplete STR even after adjustment for potential confounders (OR 2.34; 95% CI 1.20–4.64, p = 0.01).ConclusionsIMA may be a useful biomarker for the identification of incomplete STR in STEMI patients presenting to hospital within 6 h of the onset of pain.