J Korean Soc Emerg Med.  2007 Oct;18(5):375-380.

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

• Cho YS
• Lim H
• Cho YS
• Kim HJ
• Jang HY

Abstract

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) x 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.

Keyword

Ischemia modified albumin (IMA); Albuminadjusted IMA (Aa IMA)

MeSH Terms

Acute Coronary Syndrome*
Electrocardiography
Emergencies*
Emergency Service, Hospital*
Female
Humans
Ischemia*
Male
Phosphotransferases
Retrospective Studies
ROC Curve
Sensitivity and Specificity
Serum Albumin
Troponin
Phosphotransferases
Serum Albumin
Troponin