PLASMA MALONDIALDEHYDE-MODIFIED ALBUMIN IS STRONGLY RELATED TO THE PRESENCE OF ACUTE CORONARY SYNDROMES

Introduction: This study aimed to evaluate the potential value of circulating malondialdehyde-modified albumin (MMA) for diagnosing acute coronary syndromes (ACS) and myocardial ischemia, by comparing with cardiac troponin I (cTnI). Materials and methods: Plasma levels of MMA were measured in 309 sequential patients who presented to the emergency room with chest pain for which serum cTnI was measured. The patients were classified into 4 groups based on their discharge diagnoses: acute myocardial infarction (AMI), unstable angina pectoris (UAP), stable angina pectoris (SAP) and non-ischemic chest pain. The data were analyzed with Fischer's exact test. Binary logistic regression analysis relating ACS to the combination of cTnI and MMA was also performed. Results: There was a significant correlation between MMA and cTnI. Both plasma MMA and cTnI independently predicted the risk of presence of cardiac chest pain, and specifically the plasma MMA levels was a more powerful discriminating factor than cTnI. There was no association of the plasma MMA level with conventional risk factors, such as age, hypertension, diabetes mellitus, smoking and lipid profile, suggesting that increased plasma MMA level is an independent risk factor for ACS. Conclusion: Our findings suggest that both MMA and cTnI may be useful for triage of patients who present to the emergency room with chest pain and the combination of the two, which reflect endothelial injury or plaque instability and myocardial cell injury respectively, allows for a more sensitive and specific discrimination between stable coronary artery disease and ACS than troponin I alone.