Clinical significance of levels of troponin I-Ultra, ischemia modified albumin and heart-type fatty acid-binding protein in diagnosis of acute coronary syndrome

DAI Xiao-chuan; ZENG Yu-long; ZHANG Xin-yue

doi:10.3969/j.issn.1674-4055.2016.10.17

Abstract：Objective To investigate the clinical significance of levels of myocardial ischemic biochemical indexes including troponin I-Ultra (TnI-Ultra), ischemia modified albumin (IMA) and heart-type fatty acid-binding protein (H-FABP) in diagnosis of acute coronary syndrome (ACS).Methods The patients with suspected ACS (n=97) were chosen from the Central Hospital of Bazhong City from Jun. 2013 to May 2015, and finally 28 were diagnosed with unstable angina pectoris (UAP group), 30 with ST-segment elevation myocardial infarction (STEMI group), 22 with non-ST-segment elevation myocardial infarction (non-STEMI group) and 17 with non-ischemia chest pain (non-ischemia chest pain group). The venous blood samples were collected from all patients before coronary angiography (CAG). The level of TnI-Ultra was detected by using electro-chemiluminescence immunoassay (ECLIA), and levels of IMA and H-FABP were detected by using immune transmission turbidity method. The correlation among TnI-Ultra, IMA and H-FABP was reviewed in ACS patients and difference in levels of TnI-Ultra, IMA and H-FABP was compared in all groups. The values of TnI-Ultra, IMA and H-FABP and TnI-Ultra+IMA+H-FABP to the diagnosis of ACS were compared.Results All 97 patients with suspected ACS averagely aged (57.34±14.25), and among them 59 were male and 38, female. There were 80 patients diagnosed definitely with ACS, 28 with UAP (male 19, female 9, average age=58.24±12.35), 30 with STEMI (male 18, female 12 and average age=57.62±13.17), 22 with non-STEMI (male 13, female 9 and average age=58.08±14.42), and 17 with non-ischemia chest pain (male 9, female 8 and average age=57.85±10.96). The difference in age, sex, complicating diseases and medication history had no statistical significance among all groups (P>0.05). The levels of TnI-Ultra, IMA and H-FABP were higher in UAP group, STEMI group and non-STEMI group than those in non-ischemia chest pain group (P<0.05). The results of correlation analysis on TnI-Ultra, IMA and H-FABP showed that TnI-Ultra was positively correlated to IMA (r=0.340,P=0.001), TnI-Ultra was positively correlated to H-FABP (r=0.442,P<0.001), and IMA was positively correlated to H-FABP (r=0.322,P=0.001). The sensitivity of TnI-Ultra+IMA+ H-FABP in diagnosis of ACS was 93.75%, false negative rate was 6.25%, specificity was 100%, false positive rate was 0%, positive predictive value (PPV) was 100%, negative predictive value (NPV) was 77.27%, and rate of accurateness was 94.85%. The sensitivity, PPV and rate of accurateness of TnI-Ultra+IMA+H-FABP were all higher significantly than those of single index in diagnosis of ACS (P<0.05).Conclusion The levels of TnI-Ultra, IMA and H-FABP have clinical significance in combined diagnosis of ACS.