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Objective To observe the out-patients of chest pain or distress, detect the change of ischemia modified albumin(IMA) concentration in those who had cardiogenic chestpain induced by acute myocardial ischemia.Methods One hundred and twenty patients who suffered from chest pain or distress were collected except for those who had chronic heart failure or renal function insufficiency.Serum samples were collected at different time points and preserved.According to the comprehensive clinical data, the patients were classified into non-ischemic chest pain group , unstable angina group, non-ST elevated myocardialinfarction group and ST elevated myocardialinfarction group.Results One hundred and twenty cases and two hundred and thirty serum samples were collected totally, including seventyone men and forty-nine women.There were significant differences between non-ischemic chest pain group and every other group (p<0.01) , and also between ST elevated myocardialinfarction and unstable angina group(p<0.01).Conclusions The concentration of Serum IMA increases in patients with unstable coronary heart disease(CHD).It can be used to distinguish chest pain caused by acute myocardial ischemia and to reflect the severity of ischemia in the early acute coronary syndromes.