Ischemia-Modified Albumin As A Marker For Acute Aortic Dissection: A Prospective Observational Study

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Abstract Background: Delayed or misdiagnosed aortic dissection can lead to death and morbidity. Ischemia-modified albumin (IMA) measures the cobalt binding capability and has been associated with mortality in patients with acute aortic dissection (AAD). However, it is unknown whether IMA levels can differentiate AAD in patients with chest pains.Methods: A total of 100 suspected AAD patients were enrolled in this study. A cobalt-binding assay was used to determine the plasma IMA levels. In addition, the IMA levels of patients in different groups were compared based on the final diagnosis. Results: IMA levels were significantly higher in the AAD group than in the AMI, PE, and other groups (63.98 ± 14.38, 52.57 ± 9.54, 49.26 ± 10.99, 37.99 ± 6.59, respectively) within 24 hours after the onset of symptoms. The area under the curve (AUC) based on the IMA level was 0.810 (95% CI, 0.708–0.897), and the best threshold of IMA was 59.35 u/ml (specificity, 85.7% and sensitivity, 66%). The decision and clinical impact curves indicated that the IMA had an excellent standardized net benefit and could be suitable for patient diagnosis.Conclusion: IMA is elevated in AAD patients. The IMA levels have better performance for AAD than D-dimer and could be a potential biomarker with rapid and cost-effective diagnostic tests for early diagnosis of AAD. However, large-sample studies are needed to verify the findings.

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