Prognostic significance of ischemia-modified albumin in patients with acute coronary syndrome

Abstract

To improve prognosis in acute coronary syndrome, new clinical applications in terms of diagnosis, risk stratification, and treatment strategies are still under investigation. Ischemia-modified albumin was one of the novel markers of myocardial ischemia. In our study, we aimed to determine the prognostic significance of the albumin cobalt binding capacity test in patients with acute coronary syndromes. We compared the ischemia-modified albumin levels of patients with acute coronary syndrome with those of patients with stable coronary artery disease and those of normal individuals and found them to be significantly higher in the first group (P<0.05). A cutoff value of ischemia-modified albumin of 477 U/ml was found by using receiver operating characteristic curve analysis. Mortality in groups of patients whose ischemia-modified albumin levels were above 477 U (50%) was found to be significantly higher than in those whose levels were below 477 U (8.3%) (P<0.05). The sensitivity and specificity of the cutoff value, 477 U/ml, for the 1-year mortality were found to be 70 and 82%, respectively. Using the Cox regression model the relation of albumin cobalt binding capacity test results with mortality was statistically significant (beta=1.013, confidence interval 95%, P=0.01) and independent of the existence of hypertension, diabetes, and advanced age. In conclusion, ischemia-modified albumin was found to be significantly related to 1-year mortality. Prognostic significance of ischemia-modified albumin should be evaluated in large populated and randomized study groups. Afterwards, ischemia-modified albumin could be used in risk stratification modality in patients with acute coronary syndrome.

Ischemia-Modified Albumin: Is It a Reliable Diagnostic and Prognostic Marker for Myocardial Ischemia in Real Clinical Practice?

“…Addition of the IMA level to ECG and cardiac troponin T increased the sensitivity but at the cost of reduced specificity. Recently, the level of IMA has been suggested as a prognostic factor for future cardiac events in patients with ICP [16,17]. However, our data revealed that the level of IMA did not predict short-term and mid-term clinical outcomes in patients with ICP.…”

“…In addition, various other conditions, such as exercise, acidosis, or dehydration, also contribute to elevation of IMA levels [14,15]. In contrast to the investigators supporting IMA as a prognostic factor for future cardiovascular events, several teams [16,17,18]reported that IMA was unable to predict serious cardiac outcomes in the short term in patients with potential acute coronary syndrome. Thus, in the present study, we sought to investigate whether IMA is a reliable biomarker for differentiating ischemic chest pain (ICP) due to acute myocardial ischemia from nonischemic chest pain (NICP) and for predicting future coronary events in clinical practice.…”

Combinatorial Determination of Ischemia Modified Albumin and Protein Carbonyl in the Diagnosis of NonST-Elevation Myocardial Infarction

“…5). There were no correlation between age and the level of serum IMA and PC content which similar to the findings from Aparci et al [24] that the relation of albumin cobalt binding capacity test results is independent to the advanced age.…”

Can ischemia modified albumin increase diagnostic power of myocardial perfusion scintigraphy?

“…Literatürde İMA'nin miyokart iskemisi durumunda yükseldiğini ve prognostik değe-ri olduğunu gösteren çalışmalar vardır. [4,5] Miyokart iskemisinin varlığını ve boyutunu kan örneğinden ölçülen bir biyobelirteç yolu ile araştırmak klinik uygulamada oldukça yararlı olabilir. Bu biyobelirteçlerin kullanımı girişimsel olmayan testlerin revaskülarizasyon gerektiren tıkayıcı KAH'ı saptama gü-cünü de artırabilir.…”