Meta-analysis of the value of ischemia-modified albumin for early diagnosis of myocardial ischemia in acute coronary syndrome
HUANG Qianyi1 GUAN Zhongying2 HAN Huajing1 YANG Fangyu1 SHI Ting1 DIAO Qizhi1
1.Department of Clinical Laboratory Medicine, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, China;
2.Department of Clinical Laboratory Medicine, the Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Liaoning Province, Shenyang 110000, China
Abstract：Objective To systematically review the diagnostic value of ischemic modified albumin (IMA) for early myocardial ischemia in acute coronary syndrome (ACS). Methods PubMed, Embase, Web of Science, CNKI, VIP and CBM Data databases for studies about IMA in the diagnosis of ACS were searched by computers from the establishment of the database to September 2019. Two researchers screened the literature according to the inclusion and exclusion criteria, extracted data and used the QUADAS-2 tool to evaluate the risk of bias in the included studies. Based on the bivariate mixed-effects model, meta-analysis was performed using Stata 12.0 software. Results A total of 12 articles, while a total of 14 studies were included, including 1247 patients with ACS and 1377 patients with non-ischemic chest pain. The summary sensitivity of IMA diagnosis ACS was 0.77 (0.68, 0.84), specificity was 0.68 (0.57, 0.77), positive likelihood ratio was 2.4 (1.7, 3.3), negative likelihood ratio was 0.34 (0.24, 0.49), diagnostic odds ratio was 7 (4, 13) and the area under the summary receiver operator characteristic curve was 0.79 (0.75, 0.82). Conclusion IMA has certain value in the early diagnosis of ACS myocardial ischemia, combined with clinical symptoms and other diagnostic indicators can further improve the accuracy of diagnosis.
黄谦亦1 管仲莹2 韩华静1 杨方渝1 施婷1 刁奇志1. 缺血修饰白蛋白对急性冠脉综合征心肌缺血早期诊断价值的荟萃分析[J]. 中国医药导报, 2020, 17(13): 164-168,176.
HUANG Qianyi1 GUAN Zhongying2 HAN Huajing1 YANG Fangyu1 SHI Ting1 DIAO Qizhi1. Meta-analysis of the value of ischemia-modified albumin for early diagnosis of myocardial ischemia in acute coronary syndrome. 中国医药导报, 2020, 17(13): 164-168,176.
[1] Gach O，El HZ，Lancellotti P. Acute coronary syndrome [J]. Rev Med Liege，2018，73（5/6）：243-250.
[2] Mozaffarian D，Benjamin EJ，Benjamin EJ，et al. Executive Summary：Heart Disease and Stroke Statistics-2016 Update：A Report From the American Heart Association [J]. Circulation，2016，133（4）：447-454.
[3] 刘江萍.急性冠脉综合征流行病学及危险因素的研究进展[J].国际心血管病杂志，2019，46（1）：1-3.
[4] Kuběna P，?譒pinar J，Dastych M，et al. Diagnostic and prognostic biomarkers in acute coronary syndrome [J]. Vnitr Lek，2018，63（12）：935-944.
[5] Lee E，Eom JE，Jeon KH，et al. Evaluation of albumin structural modifications through cobalt-albumin binding (CAB) assay [J]. J Pharm Biomed Anal，2014，91：17-23.
[6] 曲艳吉，杨智荣，孙凤，等.偏倚风险评估系列：（六）诊断试验[J].中华流行病学杂志，2018，39（4）：524-531.
[7] Hong C，Riley RD，Chen Y. An improved method for bivariate meta-analysis when within-study correlations are unknown [J]. Res Synth Methods，2018，9（4）：73-88.
[8] Bhakthavatsala Reddy C，Cyriac C，Desle HB. Role of “Ischemia Modified Albumin”（IMA）in acute coronary syndromes [J]. Indian Heart J，2014，66（6）：656-662.
[9] Sokhanvar S，Mellati AO，Mousavinasab SN，et al. Ischemia-modified albumin（IMA）in differential diagnosis of transient myocardial ischemia from non ischemic chest pain [J]. Bratisl Lek Listy，2012，113（10）：612-615.
[10] Charpentier S，Ducassé JL，Cournot M，et al. Clinical assessment of ischemia-modified albumin and heart fatty acid-binding protein in the early diagnosis of non-ST-elevation acute coronary syndrome in the emergency department [J]. Acad Emerg Med，2010，17（1）：27-35.
[11] Talwalkar SS，Bon Homme M，Miller JJ，et al. Ischemia modified albumin，a marker of acute ischemic events：a pilot study [J]. Ann Clin Lab Sci，2008，38（2）：132-137.
[12] Sinha MK，Roy D，Gaze DC，et al. Role of “Ischemia modified albumin”，a new biochemical marker of myocardial ischaemia，in the early diagnosis of acute coronary syndromes [J]. Emerg Med J，2004，21（1）：29-34.
[13] Zhong Y，Wang N，Xu H，et al. Ischemia-modified albumin in stable coronary atherosclerotic heart disease：clinical diagnosis and risk stratification [J]. Coron Artery Dis，2012，23（8）：538-541.
[14] Kim JS，Hwang HJ，Ko YG，et al. Ischemia-modified albumin: is it a reliable diagnostic and prognostic marker for myocardial ischemia in real clinical practice? [J]. Cardiology，2010，116（2）：123-129.
[15] Hjortsh?覬j S，Kristensen SR，Ravkilde J. Diagnostic value of ischemia-modified albumin in patients with suspected acute coronary syndrome [J]. Am J Emerg Med，2010，28（2）：170-176.
[16] Roy D，Quiles J，Aldama G，et al. Ischemia Modified Albumin for the assessment of patients presenting to the emergency department with acute chest pain but normal or non-diagnostic 12-lead electrocardiograms and negative cardiac troponin T [J]. Int J Cardiol，2004，97（2）：297-301.
[17] 张平，周洪兴，白阳，等.缺血修饰白蛋白在急性冠状动脉综合征早期诊断中的应用价值研究[J].检验医学，2015， 30（6）：581-584.
[18] 李新春，刘志琴，李小红.缺血修饰白蛋白对急性冠状动脉综合征诊断价值的研究[J].医学综述，2012，18（9）：1410-1411.
[19] 游洁芸，杨承健，金艳，等.缺血修饰白蛋白在急性冠状动脉综合征诊断中的应用价值[J].检验医学，2010，25（4）：338-339.
[20] 张俊，徐志伟，李克.诊断性试验Meta分析的效应指标评价[J].中国循证医学杂志，2013，13（7）：890-895.
[21] 胡琴，陈维贤，詹茜，等.缺血修饰清蛋白对急性冠脉综合征诊断价值的荟萃分析[J].国际检验医学杂志，2013， 34（10）：1206-1208.
[22] 许汝福，熊鸿燕，李亚斐，等.诊断试验灵敏度与特异度似然比预测值的变化关系研究[J].数理医药学杂志，2008，21（5）：574-576.
[23] 龚娟芬，何迎春，王志伟，等.Logistic回归及ROC曲线综合评价卒中后血管性认知功能障碍的预测指标[J].中国现代医生，2019，57（25）：94-98，168.
[24] 王轶，魏利霞.缺血修饰白蛋白联合心肌损伤标志物早期诊断急性冠状动脉综合征的临床价值研究[J].实验与检验医学，2018，36（4）：609-611.
[25] Palma S，Delgado-Rodriguez M. Assessment of publication bias in meta-analyses of cardiovascular diseases [J]. J Epidemiol Community Health，2005，59（10）：864-869.
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