Diagnostic value of pleural effusion ischaemia-modified albumin in patients with cardiac failure

BackgroundIschaemia-modified albumin (IMA) is a relatively new marker of ischaemia. IMA has not been studied previously in pleural effusions due to congestive heart failure (CHF). The aim of our study was to assess the diagnostic value of IMA in the pleural fluid (PF) and serum for the identification of pleural effusion due to CHF.MethodsThe concentrations of pleural fluid and serum IMA were measured in a total of 40 patients: 10 with CHF and 30 with non-cardiac failure (10 with acute pulmonary embolism, 10 with parapneumonic effusion and 10 with malignancy). The area under the curve (AUC) quantified the overall diagnostic accuracy of the tests.ResultsThe study demonstrated that IMA concentration was higher in both pleural fluid and serum of CHF patients compared with non-cardiac patients. PF and serum IMA demonstrated AUCs of 0.927 (95% CI: 0.844–1.00, P < 0.001), and 0.792 (95% CI: 0.653–0.930, P = 0.006), respectively, for diagnosing effusions due to CHF. The sensitivity and specificity of PF-IMA for C...