Patients with acute chest pain remain a great diagnostic challenge to emergency physicians. Ischemia-modified albumin （IMA） is a recently developed biomarker of transient myocardial ischemia. IMA has already been li...Patients with acute chest pain remain a great diagnostic challenge to emergency physicians. Ischemia-modified albumin （IMA） is a recently developed biomarker of transient myocardial ischemia. IMA has already been licensed by the US Food and Drug Administration for diagnosis of suspected myocardial ischemia. This study aimed to assess the diagnostic value of IMA in treatment of patients with acute coronary syndrome（ACS）. IMA level was detected by ultra-filtration assay combined with albumin-cobalt binding （ACB） test as well as tests of myoglobin （MYO）, creatine kinase-MB （CK-MB） and cardiac troponin I （cTnl） in 169 consecutive patients with acute chest pain onset within 24 hours. Receiver operating characteristic （ROC） curve for IMA in diagnosing ACS was established to determine the cut-off point. The sensitivity, specificity, positive predictive value （PPV） and negative predictive value （NPV） of IMA and its combinations with other agents were analyzed. Area under the ROC curve （AUC） was 0.754. As the cut-off point for IMA in this study was 70.4 U/ml, the sensitivity, specificity, PPV and NPV of IMAwere 79.8%, 65.2%±77.7%, and 69.7%, respectively. The sensitivity and NPV of IMA combined with the conventional cardiac marker panel for the diagnosis of ACS were 93.4% and 86.0%, respectively. IMA is a useful biochemical marker for the early diagnosis ofACS. IMA combined with the conventional cardiac marker panel can improve early diagnosis of ACS compared with the traditional combinations of myocardial biochemical markers.展开更多
AIM:To evaluate the relationship between increased intraocular pressure(IOP),is chemia-modified albumin levels in serum(IMA-s)and in humor aqueous(IMA-HA)in rabbits.METHODS:Twenty-five albino New Zealand rabbits weigh...AIM:To evaluate the relationship between increased intraocular pressure(IOP),is chemia-modified albumin levels in serum(IMA-s)and in humor aqueous(IMA-HA)in rabbits.METHODS:Twenty-five albino New Zealand rabbits weighing between 2.0 and 2.8 kg were used in this pilot study.With permission from Canakkale Onsekiz Mart University Animal Ethics Committee,the IOP of both eyes of each rabbit were recorded with a Tonopen(Tono-Pen XL,Reichart Inc.,Depew,NY,USA)after the application of topical proparacaine 0.5%HCl anesthesia.Blood(4 mL)was collected from the marginal ear vein and an intracameral injection of 2.3 mg/mL sodium hyaluronate and subconjunctival dexamethasone was given in the right eye.Anterior chamber aqueous fluid was obtained using a limbal approach with a 27 gauge needle from both eyes.The left eyes were used as controls.IOP was measured on the 1st,3rdand 10thday after the initial injection,with Tonopen,IMA-s levels and IMA-HA examined simultaneously.RESULTS:Beforetheinjections,IOPwas11.4±3.0mmHg in the right eye and 11.3±3.1 mm Hg in the left eye(P】0.05).There was a statistically significant difference between IMA-s levels before the IOP increase(IMA-s0)and IMA-s levels on the 1stand 3rddays after the increase in IOP(P=0.012 and P=0.01,respectively).No difference was observed between IMA-s0and serum IMA levels on the 10thday(IMA-s10)after IOP increase(P=0.989).IMA-HA in the right eye in the first day after the injection was positively correlated with IOP(r=0.748;P=0.02).No othercorrelation is found between any other parameter with IMA-HAlevels at any test time.A statistically significant positive correlation was observed between IMA-s values and IOP on the 1stand 3rddays(r=0.398,P=0.04 and r=0.382,P=0.04,respectively).There was no correlation between IMA-s levels and increased IOP on the 10thday after IOP increase(r=0.026,P=0.902).CONCLUSION:IMA may be an important indicator of acute damage caused by diseases involving ischemic damage to the eye,especially in case of increased intraocular pressure.展开更多
文摘Patients with acute chest pain remain a great diagnostic challenge to emergency physicians. Ischemia-modified albumin （IMA） is a recently developed biomarker of transient myocardial ischemia. IMA has already been licensed by the US Food and Drug Administration for diagnosis of suspected myocardial ischemia. This study aimed to assess the diagnostic value of IMA in treatment of patients with acute coronary syndrome（ACS）. IMA level was detected by ultra-filtration assay combined with albumin-cobalt binding （ACB） test as well as tests of myoglobin （MYO）, creatine kinase-MB （CK-MB） and cardiac troponin I （cTnl） in 169 consecutive patients with acute chest pain onset within 24 hours. Receiver operating characteristic （ROC） curve for IMA in diagnosing ACS was established to determine the cut-off point. The sensitivity, specificity, positive predictive value （PPV） and negative predictive value （NPV） of IMA and its combinations with other agents were analyzed. Area under the ROC curve （AUC） was 0.754. As the cut-off point for IMA in this study was 70.4 U/ml, the sensitivity, specificity, PPV and NPV of IMAwere 79.8%, 65.2%±77.7%, and 69.7%, respectively. The sensitivity and NPV of IMA combined with the conventional cardiac marker panel for the diagnosis of ACS were 93.4% and 86.0%, respectively. IMA is a useful biochemical marker for the early diagnosis ofACS. IMA combined with the conventional cardiac marker panel can improve early diagnosis of ACS compared with the traditional combinations of myocardial biochemical markers.
基金Supported by Canakkale Onsekiz MartUniversity,Scientific Research Project Center(No.2010/206)
文摘AIM:To evaluate the relationship between increased intraocular pressure(IOP),is chemia-modified albumin levels in serum(IMA-s)and in humor aqueous(IMA-HA)in rabbits.METHODS:Twenty-five albino New Zealand rabbits weighing between 2.0 and 2.8 kg were used in this pilot study.With permission from Canakkale Onsekiz Mart University Animal Ethics Committee,the IOP of both eyes of each rabbit were recorded with a Tonopen(Tono-Pen XL,Reichart Inc.,Depew,NY,USA)after the application of topical proparacaine 0.5%HCl anesthesia.Blood(4 mL)was collected from the marginal ear vein and an intracameral injection of 2.3 mg/mL sodium hyaluronate and subconjunctival dexamethasone was given in the right eye.Anterior chamber aqueous fluid was obtained using a limbal approach with a 27 gauge needle from both eyes.The left eyes were used as controls.IOP was measured on the 1st,3rdand 10thday after the initial injection,with Tonopen,IMA-s levels and IMA-HA examined simultaneously.RESULTS:Beforetheinjections,IOPwas11.4±3.0mmHg in the right eye and 11.3±3.1 mm Hg in the left eye(P】0.05).There was a statistically significant difference between IMA-s levels before the IOP increase(IMA-s0)and IMA-s levels on the 1stand 3rddays after the increase in IOP(P=0.012 and P=0.01,respectively).No difference was observed between IMA-s0and serum IMA levels on the 10thday(IMA-s10)after IOP increase(P=0.989).IMA-HA in the right eye in the first day after the injection was positively correlated with IOP(r=0.748;P=0.02).No othercorrelation is found between any other parameter with IMA-HAlevels at any test time.A statistically significant positive correlation was observed between IMA-s values and IOP on the 1stand 3rddays(r=0.398,P=0.04 and r=0.382,P=0.04,respectively).There was no correlation between IMA-s levels and increased IOP on the 10thday after IOP increase(r=0.026,P=0.902).CONCLUSION:IMA may be an important indicator of acute damage caused by diseases involving ischemic damage to the eye,especially in case of increased intraocular pressure.
