The role of ischemia-modified albumin, high sensitivity troponin T, and other inflammatory markers in early diagnosis of acute coronary syndrome in patients presenting to the emergency department with chest pain

Aim: Early diagnosis of acute coronary syndrome (ACS) is crucial in emergency medicine. While high-sensitivity troponin (hs-Tn) is a key biomarker, its limitations in the early phase highlight the need for additional markers. Ischemia-modified albumin (IMA) has shown potential in detecting myocardial ischemia, but its clinical value remains uncertain. Materials and Methods: Patients presenting with chest pain within three hours were included. Serum IMA and hs-Tn levels were measured, and their combined diagnostic value was assessed. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were also analyzed. Results: IMA levels were significantly higher in ACS patients than in non-ACS cases (p < 0.05). ROC curve analysis showed that IMA alone had moderate diagnostic performance, but its combination with hs-Tn improved sensitivity and specificity. In the ACS group, IMA levels correlated with hs-Tn, particularly in patients with ST-elevation myocardial infarction (STEMI). NLR and PLR showed no significant differences between ACS and non-ACS patients, confirming their limited diagnostic value. Discussion: IMA appears to be a promising biomarker for early ACS detection, especially when combined with hs-Tn. This combination could enhance diagnostic accuracy and support early clinical decision-making. Conversely, NLR and PLR were not reliable indicators of ACS. Further research is needed to confirm these findings and explore the clinical applications of IMA in emergency settings.