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KMID : 0385920070180050375
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Journal of the Korean Society of Emergency Medicine
2007 Volume.18 No. 5 p.375 ~ p.380
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Clinical value of Ischemia Modified Albumin (IMA) and Albumin-Adjusted Ischemia Modified Albumin (Aa IMA) to the Patients with Suspected Acute Coronary Syndrome in Emergency Department
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Cho Young-Shin
Jang Hye-Young
Cho Young-Soon
Kim Ho-Jung
Lim Hoon
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Abstract
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Purpose: To evaluation the Ischemia Modified Albumin (IMA) and Albumin-adjusted IMA (Aa IMA) as an early parameters for acute coronary syndrome.
Methods: Retrospective consecutive patients admitted with suspected Acute Coronary Syndrome (ACS) were a assessed with clinical history taking, electrocardiography (EKG), serial cardiac enzyme (creatine kinase, CK-MB, Troponin T), and percutaneous cardiovascular intervention (PCI). IMA and Aa IMA were calculated by receiver operating characteristics (ROC) curve analysis: sensitivity, specificity, negative predictive value, positive predictive value.
Results: A total of 396 patients (201 men, 195 women; median age 63.0 years) considered at acute coronary syndrome. The ACS was diagnosed in 114/396 (28.7%). Mean IMA level of ACS group was significantly higher than that of non-ACS group (100±15 U/mL vs 93±13 U/mL, p<0.05). ROC curve area estimated 0.64. If cut off value is 95.5, the sensitivity and specificity is calculated 62%, 62%. The negative predictive value (NPV) and positive predictive value is (PPV) 79% and 40%. The Aa IMA index was calculated 〔IMA index=serum albumin concentration (g/dL)×23+IMA (U/mL)-100〕. ROC curve area estimated 0.65 and the sensitivity and specificity was 74% and 50% at a cutoff value of Aa IMA index 90. The NPV and PPV is 82% and 37%.
Conclusion: We concluded that IMA and Aa IMA are relative useful diagnostic tools as rule out ACS in Emergency Department because negative predictive value was high.
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KEYWORD
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Ischemia modified albumin, IMA, Albumin-adjusted IMA, Aa IMA
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