Ischemia-Modified Albumin (IMA) for early detection of myocardial ischemia in acute coronary syndrome with type 2 diabetes mellitus: a case control study

Mehraj A Junedi, Abdulazim A Junaidi
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Abstract

Abstract Introduction : Evaluation of the patients who present to the hospital with a complaint of chest pain or other signs suggestive of acute coronary syndrome (ACS) is time-consuming, expensive, and difficult. Most of the biochemical markers are negative in early phase acute myocardial ischemia. Recent literature reports have shown more interest in a new biochemical marker which is Ischemia-modified albumin for the detection of myocardial injury. Objective: to estimate the level of ischemia-modified albumin (IMA) as a risk factor for cardiovascular disease in diabetes mellitus patients. Materials and methods: A case-control study was undertaken with sixty Type-2 diabetic patients as cases and sixty non-diabetic healthy subjects as controls. Demographic data (sex, age), an ECG and Biochemical data were collected. Blood for IMA and HbA1C levels was collected within two hours of arrival, and IMA risk marker testing was performed before any heparin/thrombolytic treatment was started. Controlled and uncontrolled diabetic patients were determined by the level of their HBA1c and comparison with the means of IMA level in their serum. Results : The IMA was significantly increased in diabetic patients compared to healthy controls, with cut off value (0.92 IU/L), and there is also a significant increase in IMA level in uncontrolled diabetic patients (Mean ± SD; 240.55 + 52.5) that presented with acute chest pain and have signs and symptoms of cardiac ischemia when compared with the well-controlled diabetic patients(Mean ± SD; 159.8 ± 60.4). Conclusion: Ischemic Modified Albumin (IMA) level was elevated significantly in uncontrolled diabetic patients with early signs of early myocardial ischemia. Additionally, IMA estimation may improve our ability to identify ischaemic patients who are missed by current diagnostic strategies, or more confidently rule out patients who do not have ACS.
缺血修饰白蛋白(IMA)早期检测急性冠脉综合征合并2型糖尿病患者心肌缺血:一项病例对照研究
摘要简介:对以胸痛或其他提示急性冠脉综合征(ACS)体征就诊的患者进行评估耗时、昂贵且困难。急性心肌缺血早期生化指标多数为阴性。近年来的文献报道对一种新的检测心肌损伤的生化标志物缺血修饰白蛋白越来越感兴趣。目的:探讨糖尿病患者缺血修饰白蛋白(IMA)水平作为心血管疾病的危险因素。材料与方法:以60例2型糖尿病患者为病例,60例非糖尿病健康人为对照。收集人口统计资料(性别、年龄)、心电图和生化数据。在到达患者两小时内采集IMA和HbA1C水平,并在开始任何肝素/溶栓治疗前进行IMA风险标志物检测。对照和非对照糖尿病患者的HBA1c水平,并与血清IMA水平进行比较。结果:与健康对照组相比,糖尿病患者IMA水平显著升高,有截断值(0.92 IU/L),未控制的糖尿病患者IMA水平也显著升高(Mean±SD;240.55 + 52.5),与控制良好的糖尿病患者相比,出现急性胸痛并有心脏缺血体征和症状(Mean±SD;159.8±60.4)。结论:缺血修饰白蛋白(IMA)水平在未控制的糖尿病早期心肌缺血患者中显著升高。此外,IMA估计可以提高我们识别被当前诊断策略遗漏的缺血性患者的能力,或者更有信心地排除没有ACS的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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