关键词: 缺血修饰白蛋白, 运动平板试验, 隐匿型冠心病, 心肌生化标志物

Abstract: AIM: To evaluate the diagnostic value of co-detection of ischemia modified albumin (IMA) and treadmill exercise test (TET) for silent myocardial ischemia (SMI). METHODS: 80 patients [55 males and 25 females; mean age (54±8) years] with suspected SMI were selected. All patients were examined with TET and coronary arteriongraphy(CAG) in one week. IMA was detected before TET and two hours after TET. All patients were divided into CHD and NCHD groups combined with the results of CAG. Changes in the concentration of IMA were observed of two groups before and after TET. The diagnostic value of co-detection of ischemia modified albumin and treadmill exercise test was evaluated for SMI. RESULTS: Among the 80 patients, it was diagnosed as CHD 33 cases, NCHD 47 cases. There were significant higher levels of IMA after TET in CHD group (P<0.05), but no significant differences in NCHD group (P>0.05). IMA levels were significantly higher in the patients of CHD after TET than those patients of NCHD[(13.3±3.5) vs (4.7±1.8) ng/mL,P<0.01]. But before TET, there were no significant differences between CHD and NCHD groups (P>0.05). The sensitivity value was 81.8％ for IMA after TET, specificity was 76.6%, positive predictive value was 71.1%, negative predictive value was 85.7%. The sensitivity was 93.8% with the co-detection of IMA and TET, specificity was 87.5%, positive predictive value was 83.3%, negative predictive value was 95.5%. CONCLUSION: IMA is a useful biochemical marker for the early myocardial ischemia. There is a high sensitivity and negative predictive value for IMA two hours after TET in thediagnosis of SMI. There is much higher diagnostic value with the co-detection of IMA and TET.

Key words: Ischemia modified albumin, Treadmill exercise test, Silent myocardial ischemia, Myocardial biochemical marker