Albumin cobalt binding test for the diagnosis of acute coronary syndrome in patients with heart failure

Introduction/Objective. Patients with acute coronary syndrome (ACS) and a history of heart failure (HF) constitute a distinct high-risk subgroup requiring continuous monitoring due to a greater propensity for complications. This study aimed to evaluate the diagnostic accuracy of the albumin cobalt binding (ACB) test for detecting ACS in patients with HF who presented to the hospital with acute chest pain. Methods. Patients with chest pain suggestive of ACS and either known or newly diagnosed HF were included and stratified into HF with and without ACS. Diagnostic accuracy of the ACB test was assessed statistically. Results. Among 71 patients, 26 had ACS and 45 did not. ACB test values were significantly higher in the HF with ACS group (p < 0.0001). The ACB test demonstrated an area under the ROC curve of 0.99 (p < 0.0001), with sensitivity and specificity of 96.15% and 100%, respectively. The positive predictive value was 100%, and the negative predictive value was 97.8%. Conclusion: The ACB test appears to be a promising complementary biomarker rather than a replacement for troponin for identifying ACS in HF patients presenting with acute chest pain.