Document Detail


Capability of ischemia-modified albumin to predict serious cardiac outcomes in the short term among patients with potential acute coronary syndrome.
MedLine Citation:
PMID:  15967971     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Ischemia-modified albumin (IMA) has been suggested as a marker of cardiac ischemia. Little, however, is known about its capacity to predict short-term serious cardiac outcomes (death, myocardial infarction, congestive heart failure, serious arrhythmia, or refractory ischemic cardiac pain) in patients arriving at the emergency department with symptoms that may indicate cardiac ischemia. METHODS: We screened 546 patients over a 4-week period, of whom 189 fulfilled our entry criteria by presenting to an emergency department with potential cardiac-ischemia symptoms within 6 hours after chest pain, seeing an emergency physician who chose to order a troponin I test, and having no serious cardiac outcome before the troponin result became available. We followed the study patients for 72 hours to determine if any experienced a serious cardiac outcome. We calculated the likelihood ratios (LRs) of IMA findings predicting serious cardiac outcomes that could not be diagnosed at presentation with current techniques. RESULTS: Of the 189 patients, 24 had a serious cardiac outcome within 72 hours after their arrival at the emergency department. The likelihood ratios for IMA measurement within 6 hours after chest pain predicting a serious cardiac outcome within the next 72 hours were 1.35 (95% confidence interval [CI] 0.315-5.79) for IMA < or = 80 U/mL and 0.98 (95% CI 0.86- 1.11) for IMA > 80 U/mL. Conclusions: These data suggest that in patients presenting with chest pain who have not yet experienced a serious cardiac event, IMA is a poor predictor of serious cardiac outcomes in the short term.
Authors:
Andrew Worster; P J Devereaux; Diane Heels-Ansdell; Gordon H Guyatt; John Opie; Farouk Mookadam; Stephen A Hill
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne     Volume:  172     ISSN:  1488-2329     ISO Abbreviation:  CMAJ     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-06-21     Completed Date:  2005-09-06     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9711805     Medline TA:  CMAJ     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  1685-90     Citation Subset:  AIM; IM    
Affiliation:
Department of Emergency Medicine, Hamilton Health Sciences, McMaster University, Hamilton, Ont.
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MeSH Terms
Descriptor/Qualifier:
Aged
Biological Markers / blood
Chest Pain
Female
Humans
Likelihood Functions
Male
Middle Aged
Myocardial Infarction / diagnosis
Myocardial Ischemia / blood,  diagnosis*
Prognosis
Sensitivity and Specificity
Serum Albumin / analysis*
Troponin I / blood
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Serum Albumin; 0/Troponin I
Comments/Corrections
Comment In:
CMAJ. 2005 Jun 21;172(13):1697-8   [PMID:  15967973 ]
CMAJ. 2005 Nov 8;173(10):1206-7; author reply 1207   [PMID:  16275974 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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