Department of Emergency Medicine, Hanyang University College of Medicine, Seoul 04763, Korea.
Department of Emergency Medicine, College of Medicine, Hallym University, Chuncheon 24253, Korea.
Medicina (Kaunas). 2022 Apr 28;58(5):614. doi: 10.3390/medicina58050614.
The diagnostic usefulness of ischemia-modified albumin in acute coronary syndrome (ACS) has been questioned. The goal of this systematic review and meta-analysis was to see how accurate ischemia-modified albumin (IMA) was in diagnosing ACS in patients admitted to emergency departments (EDs). We searched for relevant literature in databases such as MEDLINE, EMBASE, and the Cochrane Library. Primary studies that reliably reported on patients with symptoms suggestive of ACS and evaluated IMA on admission to emergency departments were included. The QUADAS-2 tool was used to assess the risk of bias in the included research. A total of 4,761 patients from 19 studies were included in this systematic review. The sensitivity and specificity were 0.74 and 0.40, respectively, when the data were pooled. The area under the curve value for IMA for the diagnosis of ACS was 0.75, and the pooled diagnostic odds ratio value was 3.72. Furthermore, ACS patients with unstable angina had greater serum IMA levels than those with non-ischemic chest pain. In contrast to prior meta-analyses, our findings suggest that determining whether serum IMA levels are effective for diagnosing ACS in the emergency department is difficult. However, the accuracy of these findings cannot be ascertained due to high heterogeneity between studies.
缺血修饰白蛋白在急性冠状动脉综合征（ACS）中的诊断价值一直受到质疑。本系统评价和荟萃分析的目的是评估缺血修饰白蛋白（IMA）在急诊科就诊的 ACS 患者中的诊断准确性。我们在 MEDLINE、EMBASE 和 Cochrane 图书馆等数据库中搜索相关文献。纳入了可靠地报告有 ACS 症状且在急诊科入院时评估 IMA 的患者的主要研究。使用 QUADAS-2 工具评估纳入研究的偏倚风险。本系统评价共纳入了 19 项研究的 4761 名患者。数据合并后，敏感性和特异性分别为 0.74 和 0.40。IMA 对 ACS 的诊断曲线下面积值为 0.75，合并诊断优势比为 3.72。此外，不稳定型心绞痛患者的血清 IMA 水平高于非缺血性胸痛患者。与之前的荟萃分析不同，我们的研究结果表明，确定血清 IMA 水平是否对急诊科 ACS 的诊断有效具有一定难度。然而，由于研究之间存在高度异质性，这些发现的准确性尚无法确定。
