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  4. Ischemia-modified albumin improves the usefulness of standard cardiac biomarkers for the diagnosis of myocardial ischemia in the emergency department setting.
 
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Titre

Ischemia-modified albumin improves the usefulness of standard cardiac biomarkers for the diagnosis of myocardial ischemia in the emergency department setting.

Type
article
Institution
Externe
Périodique
American Journal of Clinical Pathology  
Auteur(s)
Anwaruddin, S.
Auteure/Auteur
Januzzi, J.L.
Auteure/Auteur
Baggish, A.L.
Auteure/Auteur
Lewandrowski, E.L.
Auteure/Auteur
Lewandrowski, K.B.
Auteure/Auteur
Liens vers les personnes
Baggish, Aaron Leigh  
ISSN
0002-9173
Statut éditorial
Publié
Date de publication
2005-01
Volume
123
Numéro
1
Première page
140
Dernière page/numéro d’article
145
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
We studied the role of ischemia-modified albumin (IMA) with standard biomarkers (myoglobin, creatine kinase-MB [CK-MB], troponin I [TnI]) in assessment of 200 patients with suspected myocardial ischemia admitted to the emergency department. Every case was reviewed by a cardiologist. A clinical diagnosis of ischemia was assigned and correlated with biomarker test results. Of the patients, 25 (13.0%) had myocardial ischemia. Receiver operating characteristic curves demonstrated IMA as highly sensitive but somewhat poorly specific for the presence of ischemia (area under curve, 0.63; P = .01). With a cut point of 90 U/mL, the Albumin Cobalt Binding Test had 80% sensitivity and 31% specificity for diagnosing ischemia and a negative predictive value of 92%. IMA was positive in 4 of 5 patients with electrocardiographic (ECG) evidence of ischemia and 16 of 20 patients with coronary ischemia but negative ECG. Among the same patients, the myoglobin-CK-MB-TnI triad had a sensitivity of 57%. The combination of IMA-myoglobin-CK-MB-TnI increased the sensitivity for detecting ischemia to 97%, with a negative predictive value of 92%. IMA is highly sensitive and has a high negative predictive value, which might improve the usefulness of standard biomarkers of myocardial ischemia.
Sujets

Adult

Aged

Biomarkers/blood

Creatine Kinase/blood...

Creatine Kinase, MB F...

Electrocardiography

Emergency Medical Ser...

Humans

Isoenzymes/blood

Middle Aged

Myocardial Ischemia/b...

Myocardial Ischemia/d...

Myocardium/pathology

Myoglobin/blood

Necrosis

Serum Albumin/metabol...

Troponin I/blood

PID Serval
serval:BIB_5A5DB6692031
DOI
10.1309/4bctg5ucymqfwblr
PMID
15762290
WOS
000226083900017
Permalien
https://iris.unil.ch/handle/iris/104841
Open Access
Oui
Date de création
2022-12-07T10:02:19.979Z
Date de création dans IRIS
2025-05-20T18:54:01Z
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