Ischemia-modified albumin and total antioxidant status in patients with slow coronary flow: a pilot observational study

Abstract

ÖZETAmaç: Yavaş koroner akım (YKA) önemli darlık olmaksızın epikardiyal koroner arterlerin geç opasifiye olmasıdır. Yavaş koroner akım oluşumundaki temel mekanizma koroner ateroskleroza benzer ve serbest radikal oluşumu patolojiden sorumlu olabilir. Biz bu çalışmada, normal koroner arterli hastalarla, daralma olmaksızın YKA bulunan hastalar arasında iskemi-modifiye albümin (İMA) seviyeleri ve total antioksidan durum (TAD) açısından farklılık olup olmadığını araştırdık. Yöntemler: Koroner anjiyografi sırasında YKA bulunan 30 ardışık hasta (13 erkek; ortalama yaş 56±10 yıl) ile normal koroner artere sahip olup YKA olmayan 30 kişi (13 erkek; ortalama yaş 53±11 yıl) kontrol grubu olarak bu gözlemsel enine-kesitli çalışmaya alındı. Bu çalışmada serum İMA seviyeleri, albümine göre düzeltilmiş İMA ve TAD ölçüldü. İki grup arasında serum İMA seviyeleri ve TAD'ı değerlendirmek için Student t-testi kullanıldı. Serum İMA seviyeleri ve TAD arasındaki ilişkiyi açıklamak için Pearson korelasyon testi uygulandı. Bulgular: Serum İMA seviyeleri ve albümine göre düzeltilmiş İMA her iki grupta benzerdi (p=0.432, p=0.349). Ortalama TAD değeri YKA grubunda kontrol grubuna göre daha düşük bulundu (p=0.011). Yavaş koroner akım hastalarında TAD ile serum İMA seviyeleri ve albümine göre düzeltilmiş İMA arasında negatif ilişki tespit edildi (r=-0.457, p=0.011; r=-0.509, p=0.004). Sonuç: Bu çalışma göstermiştir ki, serum İMA seviyeleri ve albümine göre düzeltilmiş İMA gruplar arasında benzerken, ortalama TAD değeri YKA grubunda kontrol grubundan daha düşük ve İMA ile negatif olarak ilişkilidir. Bu sonuçlar YKA patofizyolojisini anlamak için önemli bulunmuştur. (Anadolu Kardiyol Derg 2011; 11: 582-7) Anahtar kelimeler: Antioksidan durum, iskemi-modifiye albümin, yavaş koroner akım ABSTRACT Objective: Slow coronary flow (SCF) is defined as late opacification in the epicardial coronary arteries without significant stenosis. The underlying mechanism of SCF is similar to coronary atherosclerosis. Free radical damage may be responsible for the pathology. In this study, we aimed to investigate ischemia-modified albumin (IMA) levels and differences with regard to total antioxidant status (TAS) between patients with normal coronary arteries and patients with SCF without significant stenosis. Methods: Thirty patients who were diagnosed with SCF using coronary angiography were included in this cross-sectional observational study (13 male; mean age, 56±10 years). The control group consisted of 30 patients who had normal coronary arteries as shown by coronary angiography (13 male; mean age, 53±11 years). In this study, we assessed serum IMA levels, albumin-adjusted IMA and TAS. The Student t-test was used to compare serum IMA levels and TAS between the two groups. Pearson's correlation test was used to explore the relationship between TAS and serum IMA levels. Results: Serum IMA levels and albumin-adjusted IMA were similar in both groups (p=0.432, p=0.349). The mean value of TAS was significantly lower in the SCF group compared to control group (p=0.0...

Ischemia-modified albumin must be evaluated as an oxidative stress marker together with albumin and bilirubin in individuals with acute appendicitis

“…Importantly, appendicitis is associated with changes in serum albumin 5 . Given prior evidence indicating that serum albumin changes in acute appendicitis 5 – 6 and that albumin levels can affect the estimation of IMA 4 , 7 , it is extremely important to provide serum albumin levels and IMA values that are corrected for albumin interference, as previously reported 7 . This evidence could strongly suggest the need to evaluate IMA as an oxidative stress marker in combination with albumin in individuals with acute appendicitis.…”

Ischemia modified albumin (IMA) and albumin adjusted-IMA (AAIMA) as biomarkers for diabetic retinopathy

“…However, this is the first report demonstrating both IMA and AAIMA in patients with diabetic retinopathy. It is important to study IMA result adjusted for albumin levels, because of dependence of IMA values on serum albumin concentrations (Koc et al, 2011 Our finding of an increase in IMA values in diabetic retinopathy indicates structural/ functional/chemical modification of HSA, resulting in an increased IMA formation. Increased IMA formation is regarded as a marker of ischemia and oxidative stress.…”

“…It has also been reported that a 1% change in albumin concentration can produce a 2% opposite change in IMA values (Zapico-Muñiz et al, 2004). Given the previous evidence of decreased serum albumin levels in diabetic disease (Yukl et al, 2003), and the interference of albumin level with the IMA estimation (Koc et al, 2011;Zapico-Muñiz et al, 2004), it is important to provide IMA values corrected for albumin interference. In the present study, IMA results were corrected for albumin interference and found that, even after correcting for albumin changes, the AAIMA values were significantly higher in the patient group.…”

“…The IMA following exposure to free radicals can be measured by alterations of the binding capacity of HSA to exogenous cobalt (Bar-or et al, 2000). This albumin cobalt-binding assay (ACB) for IMA estimation is affected by serum albumin level (Koc et al, 2011).…”

“…The results were expressed as absorbance units (ABSU). Because of the dependence of IMA values on albumin concentrations, IMA results were adjusted for albumin interference (Individual serum albumin/median albumin concentration of the population X IMA), as reported by Koc et al (2011).…”