Diagnostic Value of Ischemia-Modified Albumin in Terms of Acute Coronary Syndromes in Chronic Renal Patients Admitted to Emergency Department with Chest Pain and/or Equivalent Symptoms

Year 2022, Volume: 3 Issue: 1, 70 - 78, 12.03.2022

İrfan Gökçek Bedriye Müge Sönmez Çiğdem Yücel Mebrure Beyza Gökçek Fatih Alper Ayyıldız

https://doi.org/10.48176/esmj.2022.51

Abstract

Introduction: This study aimed to reveal the diagnostic value of Ischemia-Modified Albumin (IMA) in terms of acute coronary syndromes in chronic renal patients admitted to emergency department with chest pain and equivalent symptoms.
Methods: Our study is a descriptive cross-sectional research and included 125 chronic renal patients admitted to emergency department with chest pain and/or equivalent symptoms and 96 healthy volunteers as the control group.
Results: In our study, acute coronary syndrome (ACS) was detected in 12 (9.6%) of the patients. Mean IMA level was 0.72±0.17 absorbance units (ABSU) in the group with Chronic renal disease (CRD)+ACS, 0.71±0.16 ABSU in patients with CRD but without ACS, and 0.47±0.14 ABSU in the control group. A statistically significant difference was found between the groups. While no difference between chronic renal patients in whom ACS developed and chronic renal patients in whom ACS did not develop was recorded in terms of IMA. IMA value of both patients with CRD and chronic renal patients in whom ACS developed was significantly higher than that of the healthy control group. In our study, no correlation was found between troponin levels and IMA.
Conclusion: IMA level increases in both CRD and ACS. Therefore, it was determined that IMA level did not significantly increase although ACS developed depending on already high IMA level in patients with CRD. We believe IMA cannot be safely used for the diagnosis of ACS in patients with CRD due to the low specificity rate and absence of an optimal threshold value.

Keywords

Ischemia Modified Albumin, Acute Coronary Syndrome, Chronic Renal Disease

Göğüs Ağrısı ve/veya Anjinal Eşdeğer Semptomlarla Acil Servise Başvuran Kronik Böbrek Hastalarında İskemi-Modifiye Albüminin Akut Koroner Sendromlar Açısından Tanısal Değeri

Abstract

Giriş: Bu çalışmanın amacı; göğüs ağrısı ve eşdeğer semptomlar ile acil servise başvuran kronik böbrek hastalarında İMA’nın akut koroner sendromlar açısından tanısal değerliliğini ortaya koymaktır.
Yöntemler: Çalışmamız tanımlayıcı kesitsel tipte bir araştırma olup; göğüs ağrısı ve/veya eşdeğer semptomlar ile acil servise başvuran 125 kronik böbrek hastası ve kontrol grubu olarak da 96 sağlıklı gönüllü çalışmaya dahil edilmiştir.
Bulgular: Çalışmamızda hastaların 12’sinde (%9,6) AKS saptandı. Çalışmamızda KBH+AKS’li grubun İMA düzeyi ortalaması 0,72±0,17 ABSUs, KBH’li olup AKS’si olmayan hastaların İMA düzeyi ortalaması 0,71±0,16 ABSUs ve kontrol grubunun İMA düzeyi ortalaması 0,47±0,14 ABSUs olduğu saptandı. Gruplar arasında istatistiksel olarak anlamlı farklılık saptandı (p<0,05). AKS gelişen kronik böbrek hastaları ve AKS gelişmeyen kronik böbrek hastaları arasında İMA açısından fark saptanmazken (p: 0,859); hem KBH’li hastaların hem de AKS gelişen kronik böbrek hastalarının İMA değeri sağlıklı kontrol grubuna göre anlamlı olarak yüksekti (p<0,05). Çalışmamızda troponin düzeyleri ve İMA arasında korelasyona rastlanmadı (p>0,05). KBH’li hastalarda İMA için EAA 0,877 cm2 pozitif kabul edildiği 0,05 ABSUs, değerinde sensitivite %61,5 ve spesifite % 89,6; AKS’li hastalarda İMA için EAA 0,876 cm2 pozitif kabul edildiği 0,05 ABSUs, değerinde sensitivite %83,3 ve spesifite % 61,5; KBH’li hastalarda AKS gelişimindeki İMA için EAA 0,524 cm2 pozitif kabul edildiği 0,05 ABSUs, değerinde sensitivite %83,3 ve spesifite % 9,7 olarak saptandı.
Sonuç: Gerek KBH’de gerekse AKS’de İMA düzeyi artmaktadır. Bu nedenle; KBH’li olgularda İMA’nın halihazırda yüksek olmasına bağlı olarak, AKS gelişmiş olsa dahi İMA düzeyinin anlamlı olarak yükselmediği belirlendi. Gerek spesifitenin düşük olması, gerek optimal eşik değerin bulunamamış olması nedeni ile KBH’li hastalarda; İMA’nın AKS tanısı için güvenli olarak kullanılamayacağı kanısındayız.

Keywords

İskemi-modifiye albümin, akut koroner sendrom, kronik böbrek hastalığı

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