Reduced albumin-cobalt binding with transient myocardial ischemia after elective percutaneous transluminal coronary angioplasty: A preliminary comparison to creatine kinase-MB, myoglobin, and troponin I

Bar‐Or, David; Winkler, James V.; VanBenthuysen, Karyl M.; Harris, Lisbeth; Lau, Edward; Hetzel, Fred W.

doi:10.1067/mhj.2001.114800

Cited by 183 publications

(128 citation statements)

References 29 publications

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“…The present study confirms and expands previous suggestions 5 that IMA is a useful marker of ischemia in the PCI setting. Further studies however are required to investigate the role of IMA in the broader clinical setting of patients with acute chest pain.…”

Section: Discussionsupporting

confidence: 80%

“…However, isoprostanes are thought to be a very early marker of lipid peroxidation, 16 and our sampling method may not have been quick enough to detect its rise in blood after PCI. The possibility of a dilution effect when measurements are performed in peripheral blood has to be considered, and it is also possible that in some patients the magnitude of myocardial ischemia was mild and could have escaped detection by iP measurement, unlike IMA, which appears to be sensitive to transient ischemia.The present study confirms and expands previous suggestions 5 that IMA is a useful marker of ischemia in the PCI setting. Further studies however are required to investigate the role of IMA in the broader clinical setting of patients with acute chest pain.…”

supporting

confidence: 80%

“…Our finding of raised IMA levels in patients who developed chest pain and ischemic ECG changes after PCI is comparable to previous results by other authors. 5 Increased IMA levels indicate a reduced metal binding capacity of albumin associated with cardiac ischemia and the production of oxygen free radical species. 17 It is possible that albumin acts as a "sacrificial" antioxidant to reduce injury during reperfusion.…”

mentioning

confidence: 99%

“…IMA rises in patients who develop myocardial ischemia during percutaneous coronary intervention (PCI). 5 PCI offers a clinical model of myocardial ischemia-reperfusion characterized by an increase in oxidative stress. 6 -8 ROS are produced after myocardial ischemia-reperfusion and result in the production of lipid and protein peroxidation products in the local myocardial environment.…”

mentioning

confidence: 99%

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Ischemia Modified Albumin Is a Sensitive Marker of Myocardial Ischemia After Percutaneous Coronary Intervention

Sinha

Gaze²,

Tippins³

et al. 2003

Circulation

195

122

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Background-Ischemia modified albumin (IMA; Ischemia Technologies, Inc) blood levels rise in patients who develop ischemia during percutaneous coronary intervention (PCI). It is not known whether IMA elevations correlate with increases in other markers of oxidative stress, ie, 8-iso prostaglandin F2-A (iP). Methods and Results-We compared IMA versus iP plasma levels in 19 patients (mean age 62.8Ϯ11.9 years) undergoing PCI and 11 patients (mean age 64Ϯ13.6 years) undergoing diagnostic angiography (controls). In the PCI patients, blood samples for IMA and iP were taken from the guide catheter before PCI and after balloon inflations, and from the femoral sheath 30 minutes after PCI. IMA was measured by the albumin cobalt binding (ACB) test and plasma iP by enzyme immunoassay. During PCI, all 19 patients had chest pain and 18 had transient ischemic ST segment changes. IMA was elevated from baseline in 18 of the 19 patients after PCI. Median IMA levels were higher after PCI (101.4 U/mL, 95%CI 82 to 116) compared with baseline (72.8 U/mL, CI 55 to 93; PϽ0.0001). Levels remained elevated at 30 minutes (87.9 U/mL, CI 78 to 99; PϽ0.0001) and returned to baseline at 12 hours (70.3 U/mL, CI 65 to 87; Pϭ0.65). iP levels were raised after PCI in 9 of the 19 patients. However, median iP levels were not significantly different immediately (Pϭ0.6) or 30 minutes after PCI (Pϭ0.1). In the control group, IMA and iP levels remained unchanged before and after angiography (Pϭ0.2 and 0.16, respectively). Conclusions-IMA is a more consistent marker of ischemia than iP in patients who develop chest pain and ST segment changes during PCI. Key Words: ischemia Ⅲ proteins Ⅲ angioplasty I schemia modified albumin (IMA; Ischemia Technologies, Inc), measured by the albumin cobalt binding test (ACB; Ischemia Technologies), has been shown to be a marker of myocardial ischemia. 1 ACB measures the ability of the amino terminus (N-terminus) of human albumin to bind exogenous cobalt. Under physiological conditions, transition metals can bind tightly to the exposed N-terminus of albumin. 2 In the presence of myocardial ischemia, structural changes take place in the N-terminus of the protein, 3,4 which reduce its binding capacity, possibly, in part, as a result of exposure to reactive oxygen species (ROS). IMA rises in patients who develop myocardial ischemia during percutaneous coronary intervention (PCI). 5 PCI offers a clinical model of myocardial ischemia-reperfusion characterized by an increase in oxidative stress. 6 -8 ROS are produced after myocardial ischemia-reperfusion and result in the production of lipid and protein peroxidation products in the local myocardial environment. This occurs irrespective of the mechanism responsible for ischemia, ie, increased oxygen demand or a primary reduction of coronary blood flow. 9 8-epi prostaglandin F 2␣ (iP), a prostaglandin isomer, is formed by free-radical catalyzed oxidation of arachidonic acid esterified in membrane phospholipids. 10 It represents a chemically stable end-product of lipid peroxidat...

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Section: Discussionsupporting

confidence: 80%

supporting

confidence: 80%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Ischemia Modified Albumin Is a Sensitive Marker of Myocardial Ischemia After Percutaneous Coronary Intervention

Sinha

Gaze²,

Tippins³

et al. 2003

Circulation

195

122

View full text Add to dashboard Cite

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“…This may reflect differences in baseline characteristics of our study population compared to those of the aforementioned studies. Previous studies have shown that IMA levels rise within minutes after ischemia and return to baseline within IMA cut-off point 84.4 U/mL; sensitivity 88 %; specificity 89 % 6 h [24]. Unfortunately, we did not carry out serial sampling measurements that may have given additional information about marker kinetics and may have increased assay sensitivity for ACS.…”

Section: Discussionmentioning

confidence: 99%

Estimation of Ischemia Modified Albumin (IMA) Levels in Patients with Acute Coronary Syndrome

Gurumurthy¹,

Borra²,

Yeruva³

et al. 2013

Ind J Clin Biochem

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Myocardial ischemia produces free radicals that catalyze a series of oxidative reactions that damage healthy tissues. The N-terminal sequence of albumin is one of the proteins modified by these highly reactive oxygen species and forms the ischemia modified albumin (IMA). This study involves investigations undertaken in different study groups to assess the levels of IMA. Mean serum IMA levels (U/mL) in patients with ST-segment elevated myocardial infarction (92.1 ± 10.6), non-ST-segment elevated myocardial infarction (87.3 ± 5.95) and unstable angina (UA) (88.9 ± 6.16) were significantly higher than noncardiac chest pain (77.9 ± 6.69) and also healthy subjects (54.7 ± 17.2) (p \ 0.001). IMA is a highly sensitive marker and has a high predictive value, which might prove the usefulness of this biomarker for early detection of myocardial ischemia. These data indicate a possible role of the IMA test in the early triage of patients with chest pain.

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Ischemia‐modified albumin in acute aortic dissection

Sbarouni

Γεωργιάδου

Marathias

et al. 2010

Clinical Laboratory Analysis

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Reduced albumin-cobalt binding with transient myocardial ischemia after elective percutaneous transluminal coronary angioplasty: A preliminary comparison to creatine kinase-MB, myoglobin, and troponin I

Cited by 183 publications

References 29 publications

Ischemia Modified Albumin Is a Sensitive Marker of Myocardial Ischemia After Percutaneous Coronary Intervention

Ischemia Modified Albumin Is a Sensitive Marker of Myocardial Ischemia After Percutaneous Coronary Intervention

Estimation of Ischemia Modified Albumin (IMA) Levels in Patients with Acute Coronary Syndrome

Ischemia‐modified albumin in acute aortic dissection

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