|Increased Circulatory Levels of Ischemia Modified Albumin, Protein Carbonyl, Malondialdehyde and Total Antioxidant Capacity as Prognostic Biomarkers for non-ST-segment Elevation Myocardial Infarction: A ROC Curve Analysis|
|Reza Gholikhani-Darbroud1, Fatemeh Khaki-Khatibi2, Fatemeh Mansouri3, Mojgan Hajahmadipoorrafsanjani4, Morteza Ghojazadeh5|
|1Department of Clinical Biochemistry, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
2Drug Applied Research Center and Department of Clinical Biochemistry, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
3Cellular and Molecular Research Center and Department of Genetics and Immunology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
4Cardiology Department, Seyedoshohada Cardiovascular Medical Hospital, Urmia University of Medical Sciences, Urmia, Iran
5Iranian Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Keywords : Ischemia Modified Albumin, Protein Carbonyl, Biomarker, Non-ST-segment Elevation Myocardial Infarction
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Objective: Oxidative stress by cardiac ischemia causes protein modifications in serum albumin to create Ischemia Modified Albumin (IMA) and other circulatory proteins to create Protein Carbonyl (PC), that their increase from a baseline could be used as a diagnostic tool for cardiac ischemia disease. We aimed to evaluate IMA, PC, Malondialdehyde (MDA) and Total Antioxidant Capacity (TAC) differentiation between patients with early-stage non-ST-segment Elevation Myocardial Infarction (NSTEMI) and healthy control subjects and test their sole and integrative recognition efficiency as rapid predictive biomarkers for NSTEMI.
Materials and Methods: We selected 52 patients of both sexes with diagnosis of NSTEMI within 6 hours. 52 healthy individuals without significant differences in sex and age having normal range of cTnI results were enrolled as control group. Serum samples were collected and IMA, PC, MDA, and TAC levels were quantified, and their findings were compared with serum cTnI levels as the "gold standard".
Results: Linear regression, correlation, and ROC curve analyses showed that both circulatory PC and IMA were statistically elevated in NSTEMI patients relative to control group, and both had statistically high sensitivity and specificity to rapid prediction of NSTEMI disease. Combinatorial determination of both biomarkers increased test specificity and negative predictive value (NPV).
Conclusion: Both PC and IMA contents could be used as early ischemic biomarkers for diagnosis of NSTEMI and integrative determination of both biomarkers could be used in emergency departments to fast diagnosis of NSTEMI disease.
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