Diagnostic efficacy of ischemia modified albumin and its correlation with lipid profile, oxidative stress in acute myocardial infarct patients on admission

Coronary artery disease (CAD) is predicted to be the leading cause of morbidity and mortality in developing countries by the year 2020[1,2]. Approximately 30% patients presenting at emergency department with chest pain actually develop acute myocardial infarction (AMI)[3]. Cardiac ischemia is the most common mechanism underlying acute coronary syndrome (ACS) that when prolonged, may lead to myocardial damage and cell death. Myocardial ischemia results from lack of adequate blood perfusion of myocytes, leading to a deficiency of oxygen and nutrients, thus compromising their vital functions[4]. Diagnosis of ischemia is difficult in patients presenting with acute chest pain with uninterpretable baseline electrocardiogram (ECG), normal ECG during pain, or without evidence of myocardial necrosis[5,6]. None of the traditional clinical variables, 12-lead ECG, biochemical markers of necrosis and imaging techniques can be considered a true gold standard in diagnosing or ruling out cardiac ischemia[7]. Lack of a sensitive marker hinders appropriate discharge of nonAMI patients resulting in numerous expenses and patient mismanagement[8,9]. Ideally, it is essential to identify myocardial ischemia before the onset of irreparable myocardial cell damage. Recently, a new parameter ischemia modified albumin (IMA) has been developed and observed to be very useful for the detection of acute myocardial ischemia that identifies the patients having potential coronary artery lesion, with high risk of adverse cardiac events. With these views, the present piece of work was conducted with an objective to estimate serum IMA in AMI patients and to compare its clinical performance with cardiac troponin T (CTnT) and ECG-alone as well as in combination.