The role of IMA in ruling out ischemia in patients presenting with chest pain, and its relation with the extent of coronary artery disease

BackgroundIschemia modified albumin (IMA) is an albumin that has an altered binding capacity to bind metal ions and can be used to detect myocardial ischemia in acute coronary syndrome (ACS) patients.Aim of workTo study the IMA level in patients presenting with non-ST segment elevation ACS and its diagnostic and prognostic value.Patients and methodsThis study was conducted on 50 patients with a mean age of 54.7 ± 9 yrs. Patients were grouped into group 1: unstable angina (13 patients), group 2: NSTEMI (17 patients), and group 3: control group. All patients were subjected to routine labs, cardiac biomarkers and predischarge coronary angiography and were followed up for 2 months to detect any major adverse cardiac event. IMA level was measured upon admission for all patients. All data were statistically analyzed.ResultsIMA was statistically significantly higher in groups 1 and 2 compared to group 3 patients (P value < 0.05). The optimal cutoff value to diagnose ischemic patients was 4 ng/ml. The mean IMA level was significantly cardiac biomarkers including troponin, TIMI risk score and number of the affected vessels but not correlated with the modified Gensini score (MGS), and short term prognosis. The optimal cutoff value for IMA levels to predict poor prognosis was 9.65 ng/ml.ConclusionSerum IMA is a useful marker to rule out non ischemic patients presented with suspected ACS and is significantly related to the number of affected vessels.