Ischemia modified albumin in patients of cardiac and non-cardiac chest pain

Existing biochemical markers are not suitable for assessing early myocardial ischemia particularly in first 2-6 hours of ischemia i.e. before setting in of irreparable myocardial damage. Recently ischemia modified albumin (IMA) has emerged as the earliest cardiac marker. Therefore, this study was planned to estimate IMA levels in patients of acute chest pain with or without cardiac cause. One hundred patients of acute chest pain (50 patients with cardiac cause and 50 patients with non-cardiac cause) were selected for the study and compared with 50 age and sex matched healthy controls. IMA, creatine kinase- MB (CK-MB), Troponin I, routine biochemical investigations, hemoglobin and total leucocyte count were estimated in these patients. The results were analysed statistically. IMA levels were found to be significantly elevated in patients of chest pain with myocardial ischemia as compared to the other two groups. A significant positive correlation was found between IMA levels & CKMB levels (r = +0.713, p value 0.05). Thus we conclude that IMA assay is a sensitive but not very specific marker for early detection of myocardial ischemia. IMA can be combined with other biochemical markers like CK-MB and Troponin I to increase the specificity. Other non myocardial ischemic conditions should be kept in mind while interpreting IMA values.