Title: Ischemia Modified Albumin –An Early Marker of Myocardial Ischemia
Authors: Dr R.Panimathi* M.D (Bio), D.CH, Dr Lalitha M.D
DOI: http://dx.doi.org/10.18535/jmscr/v4i7.68
Introduction: Coronary heart disease (ischemic heart disease-IHD) is projected to be the leading cause of death by 2030, accounting for 25-30% of deaths in industrialized countries. Aim and objective: To estimate serum Ischemia Modified albumin in myocardial ischemia patients and to correlate it with Ck-MB and lipid profile. Materials and Methods: The present study was conducted to estimate serum Ischemia modified albumin by Albumin Cobalt Binding Assay in fifty subjects who were admitted in the Intensive Coronary Care Unit with complaints of chest pain of less than 6 hours duration along with ECG showing S-T,T changes. This was compared with fifty healthy subjects. Results and Observation: Statistical analysis in the study group showed the mean value of Ischemia modified albumin as 88.52 Iu/ml and sensitivity of 78% which revealed a significant raise than Ck-MB [mean value of 56.50 U/Land sensitivity of 69%] during the early hours of ischemia. With an area under the curve of 0.921 and a standard error of 0.028, it also showed an asymptomatic significance of 0.001 proving it as a better predictor over Ck-MB in diagnosing myocardial ischemia. Conclusion: Values obtained suggested a significant correlation between ischemia modified albumin and CK-MB,and also with age, total cholesterol and low density lipo protein. Analysis of Ischemia modified albumin helps to diagnose myocardial ischemia at an Earlier stage in the first 2-6 hours following an ischemic event before it progresses to irreversible myocardial cell damage and necrosis, unlike other previous laboratory parameters that identify myocardial damage only after it is well established Keywords: IHD-ischemic heart disease, ACS-Acute coronary syndrome, IMA- ischemia modified albumin, 1. WORLD HEALTH ORGANISATION 1982, Technical report, ser.no. 678. 2. Douglas pzipes, Global trends in cardiovascular disease, Braunwald’s Heart Disease, 8th Edition, Edited by; Peter libby, saunder’s publishers, page14. 3. Woolf, cardio vascular system; Atherosclerosis II, PATHOLOGY Basic and systemic, by Nevilliewoolf, WB Saunders Company Ltd. Page 337. 4. Frans- J. Vandewerf, Clinical Cardiology, TEXTBOOK OF CARDIOVASCULAR MEDICINE, 3RD Edition, edited by Eric. J.Topol et-al; Lippincott Williams & Wilkins publishers, page 252. 5. Lehninger: Biosynthesis of cholesterol, steroids, and isoprenoids, PRINCIPLES OF BIOCHEMISTRY by Lehinger 4th edition , CBS publishers, page827. 6. Frederick J. Schoen, The Heart, ROBBIN’S BASIC PATHOLOGY, 8TH Edition, Edited by Vinaykumar et-al; Saunder / Elsevier publishers, page 390. 7. Peter G. Isaacson, Circulatory Disorders, Oxford Textbook Of Pathology vol- I, Edited by James odMc Gee, Oxford University press, page 526. 8. Frederick.j.schoen,Ramzi.s.cotran, Blood vessels, Robbins, Basic Pathology, 8TH edition, Edited by Vinaykumar et-al; saunder’s Elsevier publishers. Page 344. 9. S. S. Talwalker et-al; Ischemia modified Albumin, a marker of Acute Ischemic events, A pilot study, Annals Of Clinical And Laboratory Science, Jan 1, 2008; 38(2): 132-137. 10. L. Keating et-al; The prima study: Presentation ischemia modified albumin in the emergency department, EMERGENCY MEDICAL JOURNAL, Oct 1, 2006; 23(10): 764-768. 11. D. A. Morrow et-al; The search for a Biomarker of Cardiac ischemia, Clinical Chemistry, April 1, 2003; 49(4) 537-539. 12. Gary J Fagan, Albumin Cobalt Binding Test; Analytical performance of a new automated chemistry assay for the detection of IMA, JOURNAL OF CLINICAL LIGAND ASSAY, 2002; 25: vol 25, number 2, 178-187. 13. Acute Coronary Syndrome, INTERPRETATION OF DIAGNOSTIC TESTS BY Jacques Wallach, 8th edition, Lippincott, page 129. 14. Robert H Christenson et-al; Characteristics of an ACB Test for assessment of Acute Coronary Syndrome patients; Clinical Chemistry – 47:3 464- 470 (2001). 15. Chawla et-al; Ischemia Modified Albumin: A novel marker for Acute Coronary Syndrome, INDIAN JOURNAL OF CLINICAL BIOCHEMISTRY, 2006, 21 (1) 77-82. 16. Gaze DC et-al; IMA is a sensitive marker of myocardial ischemia after percutaneous coronary intervention, CIRCULATION, 2003, MAY; 107(19):2403-5. 17. Manas.k.Sinha et-al; Markers of myocardial ischemia EUROPEAN HEART JOURNAL; oxford journal, 2006, 27(6):758 18. G.Lippi, et-al; predicting Cardiac outcomes, CANADIAN MEDICAL ASSOCIATION JOURNAL, NOV 2005; 173(10) 1206-1207. 19. Guiliyan et-al; Assay of IMA, & CRP for early diagnosis of ACS, CLINICAL LABORATORY ANALYSIS, 2008; 22; 45-47.Abstract
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