Comparative Study of Potential Diagnostic Biomarkers in Myocardial Infarction with Survival and Myocardial Infarction without Survival

ABSTRACT Introduction Because of the varied presentation and associated high mortality, the identification of patients with acute myocardial infarction (MI) is very critical for patient management and has a bearing on the prognosis. The goal of present study was to correlate the diagnostic value of cardiac biomarkers in MI with survival and MI without survival. Materials and methods Diagnostic case—control study was conducted on 110 MI patients presenting to the Emergency Department within 12 hours of acute chest pain, and 120 healthy age- and sex-matched volunteers formed the control group. Serum ischemia-modified albumin (IMA), troponin I (TnI), creatine kinase-MB (CK-MB), lactate dehydrogenase (LDH), and aspartate transaminase (AST) were measured. Statistical software SYSTAT version 12 was used to analyze the data. The results were expressed in mean ± standard deviation. Comparisons of study groups and study groups with control groups were done by applying Z test. Correlation was tested by Student's t-test at 5% (p = 0.05) and 1% (p = 0.01) level of significance. Results Mean levels of serum IMA, TnI, CK-MB, LDH, and AST levels were significantly higher (p < 0.01) in patients with MI as compared with healthy controls. Serum levels of cardiac biomarkers were significantly elevated (p < 0.01) in MI patients without survival as compared with MI with survival. Conclusion The serum levels of biomarkers were increased in MI without survival as compared with MI with survival. These study data prove that these changes might be helpful to obtain a comprehensive view of the infarct size and severity of vascular stenotic lesions. How to cite this article Patil SM, Bankar M, Padalkar R, Phatak A. Comparative Study of Potential Diagnostic Biomarkers in Myocardial Infarction with Survival and Myocardial Infarction without Survival. Indian J Med Biochem 2017;21(2):106-111.

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Effect of Curcuma longa (Turmeric) on serum creatine kinase-MB and troponin I in isoproterenol induced myocardial infarction in wistar albino rats

Journal of Bangladesh Society of Physiologist ◽

10.3329/jbsp.v13i2.39477 ◽

2018 ◽

Vol 13 (2) ◽

pp. 47-53

Author(s):

Sharmin Nahar ◽

Qazi Shamima Akhter

Keyword(s):

Myocardial Infarction ◽

Body Weight ◽

Troponin I ◽

Curcuma Longa ◽

Heart Weight ◽

Control Group ◽

Albino Rats ◽

Creatine Kinase Mb ◽

The Mean ◽

Wistar Albino Rats

Background: The prevalence of myocardial infarction (MI) is increasing day by day in Bangladesh due to socioeconomic transition. Spices and herbs are important source of remedy for various diseases in human. Curcuma longa suggested to be used as an indigenous medicine for the prevention and treatment of cardiovascular disease. Objective: To observe the effect of Curcuma longa in isoproterenol induced myocardial infarction in Wistar albino rats. Methods: This experimental study was carried out in the Department of Physiology, Dhaka Medical College, Dhaka during 2015. Twenty one Wistar albino male rats, weighing 100 to 150 g (initial body weight); aged 85 to 100 days were selected for the study. After acclimatization for 14 days, the rats were divided into BC (Baseline control group), ISP-TC (Isoproterenol treated control group) and CLP-ISPT (Curcuma longa pretreated and isoproterenol treated group). Each group consisted of 7 rats. After experiment, on the 10th day, final body weight was taken, rats were sacrificed and blood samples were collected from the heart. The heart was removed and weighed. Serum creatine kinase-MB (CK-MB) level was estimated by ELISA method and Troponin I (cTnI) level by AxSYM method. The statistical analysis was done by one way ANOVA and Bonferroni test as applicable. Results: In this study, the mean percent (%) change of body weight (p<0.01), mean serum CK-MB (p<0.001) and cTnI (p<0.001) levels were significantly higher but mean heart weight was non significantly higher in ISP-TC in comparison to those of BC. Again, the mean percent (%) change of body weight (p<0.01), mean heart weight (p<0.01), mean serum CK-MB (p<0.01) and cTnI (p<0.001) levels were significantly lower in CLP-ISPT than those of ISP-TC group. Conclusion: From the results, it can be concluded that Curcuma longa may have cardioprotective effect. J Bangladesh Soc Physiol. 2018, December; 13(2): 47-53

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Evaluation of the Efficiency of N-terminal Pro-B-type Natriuretic Peptide for Diagnosis of Acute Myocardial Infarction

Sudan Journal of Medical Sciences ◽

10.18502/sjms.v15i3.7746 ◽

2020 ◽

Author(s):

Abuagla M. Dafalla ◽

Leena A. Dafalla ◽

ShamsEldein M. Ahmed ◽

Yousif A. Mohammed ◽

Adam D. Abakar ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Natriuretic Peptide ◽

Predictive Value ◽

Troponin I ◽

Venous Blood ◽

Cardiac Biomarkers ◽

Control Group ◽

Heart Cell ◽

Cardiac Biomarker

Background: Cardiac diseases are one of the major causes of death worldwide with increasing incidence rate per year, particularly in developing countries such as Sudan owing to urbanization and changing lifestyle. Myocardial infarction is a consequence of the imbalance between the heart blood supply and the required heart cell; this disorder leads to necrosis of myocardium and may cause death. It could be diagnosed by at least two of the following criteria: chest pain, electrocardiography (ECG) elevation, and levels on cardiac biomarkers. This study aimed to evaluate the efficiency of N-terminal pro-B-type natriuretic peptide (NTproBNP) for the diagnosis of acute myocardial infarction (AMI). Methods: This analytical case–control hospital-based study was conducted on a total of 70 individuals, of which 40 participants were suspected of or diagnosed with AMI, while 30 healthy subjects were included as a control group. Three ml of venous blood were collected in lithium heparin containers. Troponin I (TnI) as a cardiac biomarker was measured by TOSOH AIA-360, while the NTproBNP level was detected using I-Chroma II. Personal and clinical data were collected directly from each participant using a predesigned questionnaire. Results: A significant increase in the TnI level (mean: 13.13 ± 18.9 ng/ml) and NTproBNP (mean: 5756.5 ± 8378.2 pg/mL) in AMI patients were detected when compared with control mean (0.02 ± 0.00 ng/ml and 57.8 ± 42.32 pg/mL, respectively). Conclusions: NTproBNP gave a high sensitivity (87.5%), specificity (100%), positive predictive value (100%), and negative predictive value (85.7%) in the diagnosis of AMI when compared with another cardiac biomarker such as TnI. Keywords: acute myocardial infarction, NTproBNP, troponin I, Medani Heart Center, Sudan

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Antioxidant and Anti-Inflammatory Effects of Curcumin Nanoparticles on Drug-Induced Acute Myocardial Infarction in Diabetic Rats

Antioxidants ◽

10.3390/antiox8100504 ◽

2019 ◽

Vol 8 (10) ◽

pp. 504 ◽

Cited By ~ 9

Author(s):

Boarescu ◽

Bocșan ◽

Gheban ◽

Bulboacă ◽

...

Keyword(s):

Oxidative Stress ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Creatine Kinase ◽

Serum Levels ◽

Control Group ◽

Protective Effects ◽

Curcumin Nanoparticles ◽

Creatine Kinase Mb ◽

Anti Inflammatory

We have investigated the cardio-protective effects of pretreatment with curcumin nanoparticles (CUN) compared to conventional curcumin (CUS) on the changes in oxidative stress parameters and inflammatory cytokine levels during induced acute myocardial infarction (AMI) in rats with diabetes mellitus (DM). DM was induced with streptozotocin, and AMI with isoproterenol. Eight groups of seven Wister Bratislava rats were included in the study. The N-C was the normal control group, AMI-C was the group with AMI, DM-C was the group with DM, and DM-AMI-C was the group with DM and AMI. All four groups received saline solution orally during the whole experiment. S-DM-CUS-AMI and S-DM-CUN-AMI groups received saline for seven days prior to DM induction and continued with CUS (200 mg/kg bw, bw = body weight) for S-DM-CUS-AMI and CUN for S-DM-CUN-AMI (200 mg/kg bw) for 15 days before AMI induction. The CUS-DM-CUS-AMI group received CUS (200 mg/kg bw), while the CUN-DM-CUN-AMI received CUN (200 mg/kg bw) for seven days prior to DM induction, and both groups continued with administration in the same doses for 15 days before AMI induction. CUS and CUN prevented elevation of creatine kinase, creatine kinase-MB, lactate dehydrogenase in all groups, with better results in the CUN (S-DM-CUN-AMI and CUN-DM-CUN-AMI groups). CUS and CUN significantly reduced serum levels of oxidative stress markers (malondialdehyde, the indirect assessment of nitric oxide synthesis, and total oxidative status) and enhanced antioxidative markers (total antioxidative capacity and thiols, up to 2.5 times). All groups that received CUS or CUN showed significantly lower serum levels of tumor necrosis factor-alpha, interleukin-6, and interleukin-1β. The best antioxidative and anti-inflammatory effects were obtained for the group that received CUN before DM induction (CUN-DM-CUN-AMI group). Pretreatment with CUN proved higher cardio-protective effects exerting an important antioxidative and anti-inflammatory impact in the case of AMI in DM.

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Automatizáltan mérhető biomarkerek az akut myocardialis infarctus diagnosztikájában

Orvosi Hetilap ◽

10.1556/650.2015.30145 ◽

2015 ◽

Vol 156 (24) ◽

pp. 964-971

Author(s):

Ferenc Kovács ◽

Ibolya Kocsis ◽

Marina Varga ◽

Enikő Sárváry ◽

György Bicsák

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Creatine Kinase ◽

Troponin I ◽

Troponin T ◽

High Sensitivity ◽

Cardiac Biomarkers ◽

Fatty Acid Binding ◽

High Sensitivity Troponin ◽

Creatine Kinase Mb

Introduction: Cardiac biomarkers have a prominent role in the diagnosis of acute myocardial infarction. Aim: The aim of the authors was to study the diagnostic effectiveness of automated measurement of cardiac biomarkers. Method: Myeloperoxidase, high-sensitivity C-reactive protein, myoglobin, heart-type fatty acid binding protein, creatine kinase, creatine kinase MB, high-sensitivity troponin I and T were measured. Results: The high-sensitivity troponin I was the most effective (area under curve: 0.86; 95% confidence interval: 0.77–0.95; p<0.001) for the diagnosis of acute myocardial infarction. Considering a critical value of 0.35 ng/mL, its sensitivity and specificity were 81%, and 74%, respectively. Combined evaluation of the high-sensitivity troponin T and I, chest pain, and the electrocardiogram gave the best results for separation of acute myocardial infarction from other diseases (correct classification in 62.5% and 98.9% of patients, respectively). Conclusions: Until a more sensitive and specific cardiac biomarker becomes available, the best method for the diagnosis of acute myocardial infarction is to evaluate electrocardiogram and biomarker concentration and to repeat them after 3–6 hours. Orv. Hetil., 2015, 156(24), 964–971.

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A Comparative Study on the Diagnostic Utility of Creatine Kinase-MB (Myocardial Band) Mass Estimation Over Its Activity Measurement in Patients with Acute Myocardial Infarction in a Tertiary Care Hospital in Puducherry

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/501 ◽

2021 ◽

Vol 8 (30) ◽

pp. 2724-2730

Author(s):

Nikhila Suresh Kumar ◽

Sivaa Rajendran ◽

Sunil Kumar Nanda ◽

Mark Christopher ◽

Ravichandran Kandasamy

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Creatine Kinase ◽

Cardiovascular Diseases ◽

Comparative Study ◽

Troponin I ◽

Accurate Diagnosis ◽

Care Hospital ◽

Normal Range ◽

Creatine Kinase Mb

BACKGROUND Cardiovascular diseases (CVDs) are one of the major health problems and leading cause of death worldwide. Acute myocardial infarction (AMI) is one of the cardiovascular diseases which has high mortality in early hours of presentation and hence early and accurate diagnosis is important to reduce the morbidity and mortality. Troponin I and CKMB (Creatine Kinase-Myocardial Band) activity are the routine biomarkers used for early diagnosis of AMI. Since there is a high degree of instability in the measurement of CKMB activity and also there are frequent noncorrelation with the Troponin I levels, we aimed to estimate and compare the levels of CKMB mass and CKMB activity in patients with and without AMI. METHODS This comparative study included 40 cases and 40 controls. Cases were adult patients between the age group of 30 -70 years diagnosed with AMI by electrocardiogram (ECG) and positive troponin I, and controls were who presented with non myocardial infection (MI) chest pain. Blood samples were collected to estimate CKMB activity and CKMB mass. RESULTS The median value of CKMB activity in controls was 21 IU/L (IQR 13.25-27.75) and that in cases was 40 IU/L (IQR 30.25-94.25) and this difference is statistically significant. The median value of CKMB mass in controls was 5 ngmL (IQ 4-6) and that in cases was 19.50 ng/mL (IQR 6-61.50) which is also statistically significant in differentiating both. In Spearman correlation test, both showed a better statistical significance and correlation in cases (r = 0.787). It was evident that the median value of CKMB activity in controls was higher than that of the normal range for CKMB activity which is 8-16 IU/L, but the median value of CKMB mass in controls was well within the normal range of 5- 10 ng/mL, considering it to be a better marker for eliminating false positive results. CONCLUSIONS CKMB mass can be considered as a better marker than CKMB activity for accurate diagnosis of AMI along with troponin I. KEYWORDS Cardiovascular Diseases, Biomarker, Acute Myocardial Infarction, CKMB Mass, CKMB Activity

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Cardiac biomarkers in premature calves with respiratory distress syndrome

Acta Veterinaria Hungarica ◽

10.1556/004.2016.004 ◽

2016 ◽

Vol 64 (1) ◽

pp. 38-46 ◽

Cited By ~ 3

Author(s):

Ugur Aydogdu ◽

Ramazan Yildiz ◽

Hasan Guzelbektes ◽

Alparslan Coskun ◽

Ismail Sen

Keyword(s):

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Troponin I ◽

Troponin T ◽

Venous Blood ◽

Gas Analysis ◽

Cardiac Biomarkers ◽

Control Group ◽

Creatine Kinase Mb

The aim of this study was to determine the clinical relevance of cardiac biomarkers [troponin I and T, creatine kinase-MB fraction (CK-MB) and lactate dehydrogenase (LDH)] in premature calves with respiratory distress syndrome. Seventy premature calves were admitted to the clinic within 24 h after birth. Respiratory distress syndrome was diagnosed in premature calves by clinical examination and venous blood gas analysis. Ten healthy calves, aged 5 days, were used as control. Cardiac troponin I and T were analysed using ELISA and ELFA, respectively. Serum CK-MB and LDH were also analysed in an automatic analyser. The calves had low venous pH, pO2, O2 saturation and high pCO2 values consistent with dyspnoea, hypoxaemia, and inadequate oxygen delivery. Mean serum troponin I, troponin T, CK-MB and LDH levels were increased in the premature calves compared to the control group. In conclusion, the results in this study demonstrated that serum CK-MB, troponin I and troponin T concentrations could be used for evaluating myocardial injury in premature calves with respiratory distress syndrome.

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A Four-MicroRNA Panel in Peripheral Blood Identified as an Early Biomarker to Diagnose Acute Myocardial Infarction

Frontiers in Physiology ◽

10.3389/fphys.2021.669590 ◽

2021 ◽

Vol 12 ◽

Author(s):

Liang Chen ◽

Jie Bai ◽

Jun Liu ◽

Huihe Lu ◽

Koulong Zheng

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Peripheral Blood ◽

Troponin I ◽

Characteristic Curve ◽

Disease Onset ◽

Diagnostic Value ◽

Control Group ◽

Expression Levels ◽

Creatine Kinase Mb

Objective: This study aimed to evaluate suitable circulating microRNAs (miRNAs) as diagnostic biomarkers of acute myocardial infarction (AMI).Methods: Patients with AMI were enrolled as study participants. All patients with AMI coming from the Second Affiliated Hospital of Nantong University between October 1, 2017 and May 31, 2019 were screened. At the same time, 80 patients with coronary angiographic stenosis <50% during the same period were selected as the control group. Peripheral blood samples were collected at different time points (0, 6, 12, and 24 h after disease onset) to detect the expression of a previously identified promising four-microRNA panel. The expression levels of miRNAs were tested by real-time polymerase chain reaction (RT-PCR), and the receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of circulating miRNAs.Results: Based on the inclusion and exclusion criteria, 80 patients with AMI and 80 controls were enrolled in this study. The expression of circulating miR-1291, miR-217, miR-455-3p, and miR-566 was significantly downregulated in patients with AMI compared with controls. The area under the ROC curve (AUC) of circulating miR-1291, miR-217, miR-455-3p, and miR-566 were 0.82, 0.79, 0.82, and 0.83, respectively. The AUC of these four miRNAs was 0.87 with 83% sensitivity and 87% specificity. The expression peaks of these four miRNAs occurred earlier than those of cardiac troponin I (cTnI) and creatine kinase-MB (CK-MB). Furthermore, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis showed that the targets of these four miRNAs were significantly enriched in several signaling pathways associated with AMI progression.Conclusion: Circulating miR-1291, miR-217, miR-455-3p, and miR-566 expression levels were significantly lower in patients with AMI; and combined, this panel of four miRNAs acted as a novel and potential early diagnostic biomarker of AMI.

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Cardioprotective effects of (E)-4-hydroxy-N′-(1-(3-oxo-3H-benzo[f]chromen-2-yl)ethylidene)benzohydrazide: a newly synthesized coumarin hydrazone against isoproterenol-induced myocardial infarction in a rat model

Canadian Journal of Physiology and Pharmacology ◽

10.1139/cjpp-2019-0085 ◽

2019 ◽

Vol 97 (10) ◽

pp. 989-998 ◽

Cited By ~ 1

Author(s):

Lakhdar Ghazouani ◽

Emna Khdhiri ◽

Afoua Elmufti ◽

Anouar Feriani ◽

Meriam Tir ◽

...

Keyword(s):

Myocardial Infarction ◽

Troponin T ◽

Cardiac Injury ◽

Serum Levels ◽

Heart Tissue ◽

Vehicle Control ◽

Cardiac Biomarkers ◽

St Segment Elevation ◽

St Segment ◽

Creatine Kinase Mb

The current study was carried out to evaluate the effect of pretreatment and co-treatment with a newly synthesized coumarin hydrazone, (E)-4-hydroxy-N′-(1-(3-oxo-3H-benzo[f]chromen-2-yl)ethylidene)benzohydrazide (hereinafter EK6), against isoproterenol-induced myocardial infarction in rats. Changes in biochemistry, cardiac biomarkers, electrocardiography, and histopathology after treatment with EK6 or acenocoumarol (Sintrom) were studied. Animals were randomly divided into 4 groups: vehicle control (C), isoproterenol + Sintrom (ISO + Sin), isoproterenol + EK6 (ISO + EK6), and isoproterenol (ISO). Myocardial infarction was induced by subcutaneous ISO administration at a dose of 85 mg·kg–1·day–1 with a drug-free interval of 24 h on days 6 and 7. Treatment with ISO led to significant elevation (p < 0.05) in serum levels of cardiac injury biomarkers, namely cardiac troponin-T, lactate dehydrogenase, creatine kinase-MB, alanine aminotransferase, and aspartate aminotransferase compared with levels in the vehicle control. A change in the lipid profile was also observed as a significant increase in total cholesterol and triglycerides. Furthermore, ISO caused significant alterations in the electrocardiogram pattern, including significant ST-segment elevation, significant decreased R wave amplitude, and significant increase in heart rate (16%) as well as marked changes in the histopathology of the heart tissue. Pretreatment and co-treatment with newly synthesized coumarin hydrazone restored all ISO-induced biochemical, lipid, cardiac, and histopathological changes in rats with myocardial infarction.

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Cardiac biomarkers and blood metabolites in cows with clinical ketosis

Semina Ciências Agrárias ◽

10.5433/1679-0359.2019v40n6supl3p3525 ◽

2019 ◽

Vol 40 (6Supl3) ◽

pp. 3525 ◽

Cited By ~ 1

Author(s):

Gliére Silmara Leite Soares ◽

Ana Clara Sarzedas Ribeiro ◽

Jobson Filipe de Paula Cajueiro ◽

Rodolfo José Cavalcanti Souto ◽

Emanuel Felipe de Oliveira Filho ◽

...

Keyword(s):

Creatine Kinase ◽

Dairy Cows ◽

Troponin I ◽

Pearson Correlation ◽

Clinical Signs ◽

Central Nervous System Involvement ◽

Cardiac Biomarkers ◽

Control Group ◽

Stage Of Lactation ◽

Creatine Kinase Mb

The increase in energy imbalance at the beginning of lactation leads to metabolic disorders, especially clinical ketosis, in highly productive dairy cows. The objective of this study is to evaluate the clinical characteristics, biochemical parameters, and cardiac biomarkers creatine kinase MB isoenzyme (CK-MB) and cardiac troponin I (cTnI) of 15 cows diagnosed with clinical ketosis treated at the Bovine Clinic of Garanhuns at the Federal Rural University of Pernambuco. Nine of the 15 cows were diagnosed with primary ketosis and six had concomitant diseases, including left abomasal displacement, metritis, pneumonia, and renal failure. The observed clinical signs were non-specific and included decreased appetite and milk production and weight loss. Approximately 53% of the animals had central nervous system involvement. For biochemical evaluation, 15 high-production healthy dairy cows at the initial stage of lactation served as the control group. The data were subjected to analysis of variance for simultaneous comparison between two means allowing testing the hypothesis on the means of the different groups and subjected to Pearson correlation at a level of significance of 5%. The levels of ?-hydroxybutyrate (BHB), non-esterified fatty acids (NEFA), glucose, fructosamine, total protein, albumin, creatinine, aspartate aminotransferase, creatine kinase, CK-MB, and cTnI were higher in the group with ketosis. The diseased animals presented changes in glycemia, reduction in tissue sensitivity to insulin, and a lower RQUICKI-BHB index, especially hyperglycemic animals. The increase in the levels of cardiac biomarkers suggests the occurrence of myocardial injury associated with bovine ketosis.

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Study of Ischemia Modified Albumin as New Potential Diagnostic Biomarker In Acute Myocardial Infarction.

VIMS Health Science Journal ◽

10.46858/vimshsj.7201 ◽

2020 ◽

Vol 7 (2) ◽

pp. 41-46

Author(s):

Dr. Dhananjay V. Andure ◽

Dr. Sangita. M. Patil ◽

Dr. M. P. Bankar ◽

Dr. R. K. Padalkar ◽

Dr. A. P. Pathak

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Creatine Kinase ◽

Chest Pain ◽

Predictive Value ◽

Troponin I ◽

Control Group ◽

Diagnostic Biomarker ◽

Ischemia Modified Albumin ◽

Creatine Kinase Mb

Background: Because of the varied presentation and associated high mortality the identification of patients with acute myocardial infarction is very critical for the patient management and has a bearing on the prognosis. Only about 22% patients admitted to cardiac care centers with chest pain having truly myocardial infarction. Aim: The goal of present study was to assess diagnostic value of serum ischemia modified albumin and compare it with sensitive cardiac troponin I and Creatine Kinase-MB in acute myocardial infarction. Methods: A diagnostic case control study was conducted on 102 patients presenting to the Emergency Department within 6 hrs of acute chest pain and 115 healthy age and sex matched volunteers formed the control group. Serum ischemia modified albumin level was estimated by albumin cobalt binding test using digital spectrophotometer, while troponin I was measured by immunofluroscence assay and creatine Kinase-MB was determined by immunoinhibition method. The sensitivity and specificity of ischemia modified albumin, troponin I and creatine kinase-MB for detection of acute myocardial infarction were analyzed. The results of ischemia modified albumin, troponin I and creatine kinase-MB alone and in combination were correlated. Results: Ischemia modified albumin (p<0.05) and troponin I (p<0.001) concentrations were significantly higher in acute myocardial infarction than healthy controls. Sensitivity, specificity, positive predictive value and negative predictive value of ischemia modified albumin for detection of acute myocardial infarction was 88.24%, 93.91%, 92.78% and 90.00% compared to 86.27%, 93.04%, 91.67% and 88.43% respectively for the troponin I and 78.43%, 100%, 100%, and 83.94% for creatine kinase-MB. Combined use of ischemia modified albumin, troponin I, creatine kinase-MB significantly enhanced the sensitivity to 96%. The area under the receiver operating characteristic curve of ischemia modified albumin in acute myocardial infarction was 0.90. Conclusion: Ischemia modified albumin is a new potential diagnostic biomarker used together with other gold standard cardiac biomarkers can improve early diagnosis of acute myocardial infarction.

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