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首页> 外文期刊>Journal of Clinical and Diagnostic Research >The Clinical Assessment of Ischaemia Modified Albumin and Troponin I in the Early Diagnosis of the Acute Coronary Syndrome
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The Clinical Assessment of Ischaemia Modified Albumin and Troponin I in the Early Diagnosis of the Acute Coronary Syndrome

机译：缺血性白蛋白和肌钙蛋白I在急性冠状动脉综合征早期诊断中的临床评估

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Background: An early identification of the patients with the Acute Coronary Syndrome (ACS) is of prime importance, due to the associated very high mortality. Only about 22% of the patients who present at the emergency cardiology care centres with chest pain, have coronary disease. Ischaemia modified albumin has already been licensed by the US Food and Drug Administration for the diagnosis of suspected myocardial ischaemia.Aim: The goal of the present study was to assess the diagnostic value of serum ischaemia modified albumin and to compare it with sensitive cardiac troponin I in patients with the acute coronary syndromes like unstable angina and acute myocardial infarction.Methods: A diagnostic case control study was conducted on 102 patients who presented to the Emergency Department within 6 hrs of having acute chest pain and on 110 healthy age and sex matched volunteers who formed the control group. The serum Ischaemia Modified Albumin level was estimated by the albumin cobalt binding test by using a digital spectrophotometer, while Troponin I was measured by doing an immunofluroscence assay. A receiver operating characteristic curve was established for ischaemia modified albumin, to determine the cut-off point. The sensitivity and the specificity of ischaemia modified albumin and troponin I for the detection of acute coronary syndromes, were analyzed. The results of ischaemia modified albumin and troponin I alone and in combination, were correlated.Results: The ischaemia modified albumin (p<0.05) and the troponin I (p<0.001) concentrations were significantly higher in acute myocardial infarction and in unstable angina than in the healthy controls. The sensitivity and the specificity of ischaemia modified albumin for the detection of acute coronary syndromes was 88% and 93% as compared to 87% and 75% respectively for troponin I. The combined use of ischaemia modified albumin and troponin I significantly enhanced the sensitivity to 96%. The area which was under the Receiver Operating Characteristic (ROC) curve of ischaemia modified albumin in acute coronary syndromes was 0.90.Conclusion: Ischaemia modified albumin is a useful biochemical marker for the early diagnosis of acute coronary syndrome. The combined use of ischaemia modified albumin and cardiac troponin I enhances the sensitivity and specificity. Hence, a combination of ischaemia modified albumin and cardiac troponin I can be used as a more precise diagnostic marker for Acute Coronary Syndrome.
机译：背景：由于相关的极高死亡率，早期识别急性冠脉综合征（ACS）患者至关重要。在急诊心脏病治疗中心出现胸痛的患者中，只有约22％患有冠心病。缺血修饰的白蛋白已获得美国食品和药物管理局的许可用于诊断可疑的心肌缺血。目的：本研究的目的是评估血清缺血修饰的白蛋白的诊断价值，并将其与敏感的心肌肌钙蛋白I进行比较。方法：对102名在急性胸痛后6小时内就诊至急诊科的患者以及110名年龄和性别相匹配的健康志愿者进行了诊断病例对照研究。组成对照组的人。通过使用数字分光光度计通过白蛋白钴结合测试估计血清局部缺血修饰的白蛋白水平，而通过进行免疫荧光测定法测量肌钙蛋白I。建立了缺血修饰白蛋白的受体工作特征曲线，以确定临界点。分析了缺血修饰的白蛋白和肌钙蛋白I对检测急性冠脉综合征的敏感性和特异性。结果：急性心肌梗死和不稳定型心绞痛中缺血修饰白蛋白和肌钙蛋白I单独使用或联合使用的结果具有相关性。结果：缺血心肌修饰白蛋白（p <0.05）和肌钙蛋白I（p <0.001）的浓度显着高于急性心肌梗死和不稳定型心绞痛在健康的对照中。缺血修饰白蛋白检测急性冠脉综合征的敏感性和特异性分别为88％和93％，而肌钙蛋白I分别为87％和75％。肌钙蛋白I将敏感性显着提高到96％。急性冠脉综合征的局部缺血修饰白蛋白的受体工作特征（ROC）曲线下面积为0.90。结论：局部缺血修饰的白蛋白是急性冠脉综合征早期诊断的有用生化指标。缺血修饰的白蛋白和心肌肌钙蛋白I的组合使用可提高敏感性和特异性。因此，缺血修饰的白蛋白和心肌肌钙蛋白I的组合可以用作急性冠状动脉综合征的更精确的诊断标记。

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