The Search for a Biomarker of Cardiac Ischemia

Morrow, David A.; Lemos, James A. de; Sabatine, Marc S.; Antman, Elliott M.

doi:10.1373/49.4.537

Cited by 72 publications

(43 citation statements)

References 22 publications

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“…MDA levels were also elevated in β-TM patients (median [IQR], 30 nmol/ ml) with a range of 10-112 nmol/ml compared with the control group (median [IQR], 10 [7][8][9][10][11][12][13][14][15] nmol/ml; range 5-18 nmol/ml); p < 0.001 (Table 1 and Figure 1).…”

Section: Levels Of Ima and Mda In Patients With β-Tm And Healthy Contmentioning

confidence: 98%

“…When myocardial ischemia (MI) occurs, hypoxia followed by acidosis and destruction of Na + -K + pump leads to formation of IMA by cleavage of the first two amino acids (Asp-Ala) of the HSA N-terminus. IMA is known to have low binding affinities toward transition metals [14,15]. IMA is currently used as an early marker for myocardial ischemia and acute coronary syndrome [16].…”

Section: Introductionmentioning

confidence: 99%

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Ischemia-modified albumin as a marker of vascular dysfunction and subclinical atherosclerosis in β-thalassemia major

et al. 2017

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Background: Ischemia-modified albumin (IMA) is an altered type of serum albumin that forms under conditions of oxidative stress and an independent predictor of major adverse cardiovascular events. Objectives: To measure the levels of IMA in 45 children and adolescents with β-thalassemia major (β-TM) compared with 30 healthy controls and assess its relation to lipid peroxidation, vascular complications and subclinical atherosclerosis. Methods: β-TM patients without symptoms of heart disease were studied focusing on transfusion history, chelation therapy, serum ferritin, malondialdehyde (MDA) and IMA levels. Echocardiography was performed and carotid intima media thickness (CIMT) was assessed. Results: IMA and MDA levels were significantly higher in β-TM patients compared with controls (p < 0.001). IMA was higher among patients with heart disease, pulmonary hypertension risk and serum ferritin ≥2500 µg/l than those without. TM patients compliant to chelation had significantly lower IMA levels. IMA levels were positively correlated to MDA and CIMT while negatively correlated to ejection fraction and fractional shortening. Conclusion: Our results highlight the role of oxidative stress in the pathophysiology of vascular complications in thalassemia. IMA could be useful for screening of β-TM patients at risk of cardiopulmonary complications and atherosclerosis because its alteration occurs in early subclinical disease.

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Section: Levels Of Ima and Mda In Patients With β-Tm And Healthy Contmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Ischemia-modified albumin as a marker of vascular dysfunction and subclinical atherosclerosis in β-thalassemia major

et al. 2017

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“…Furthermore, although we have several markers of irreversible myocardial necrosis, a major current deficiency is that we have no satisfactory markers of reversible myocardial ischemia (24 ). The development of such markers would permit biochemical confirmation of unstable angina, which must currently be diagnosed by a combination of a history consistent with typical angina pectoris and electrocardiographic findings of labile ST-segment and T-wave changes.…”

Section: Unmet Needs With Current Cardiovascular Biomarkers For Acsmentioning

confidence: 99%

Integration of Proteomic-Based Tools for Improved Biomarkers of Myocardial Injury

2010

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BACKGROUND:Given the mounting evidence in favor of early pharmacologic and catheter-based interventions for patients across the spectrum of acute coronary syndromes, discovering novel diagnostically sensitive and specific biomarkers that provide biochemical proof of early or reversible myocardial injury could have a substantial positive impact on patient care. CONTENT:To address unmet needs in disease biomarkers, investigators have turned to proteomics approaches. We describe advances in proteomics discovery technologies based on liquid chromatographytandem mass spectrometry that facilitate the unbiased analysis of low-abundance blood proteins. We detail the development of emerging techniques to enhance the biomarker verification process, such as accurate inclusion mass screening, stable isotope dilutionmultiple reaction monitoring-mass spectrometry (SID-MRM-MS), and stable isotope standards with capture by antipeptide antibodies, which combines the advantages of specific immunoaffinity enrichment of a target peptide with the structural specificity and quantitative capabilities of SID-MRM-MS. We highlight new assays incorporating these techniques for troponin I, a representative low-abundance cardiac biomarker, and interleukin-33, an emerging novel marker of myocardial stress for which no existing ELISA exists. We demonstrate that troponin I and interleukin-33 peptides have a linear, dynamic range spanning 4 orders of magnitude and limits of detection of approximately 0.5 g/L back-calculated to the protein concentration.

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“…But Ischemia Modified Albumin lacks its ability to bind to cobalt which forms the basis for Albumin cobalt binding assay in measuring Ischemia Modified Albumin in myocardial ischemia 11 .IMA starts increasing within 6 to 10 minutes of ischemia, reaches a peak by 4 hrs and returns to baseline after 6 hrs in transient ischemic conditions, like after Percutaneous transluminal angioplasty. Whereas the N-Terminal oxidative damage to albumin is cumulative and the repair is slow in cardiac ischemia, and the level also will not raise after 6 hours 12,13 .…”

Section: Ischemia Modified Albuminmentioning

confidence: 99%