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      Ischemia-modified albumin use as a prognostic factor in coronary bypass surgery

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          Abstract

          Background

          Various types of markers have been used so far in order to reveal myocardial perfusion defect. However, these markers usually appear in the necrosis phase or in the late stage. Having been the focus of various investigations recently, ischemia-modified albumin (IMA) is helpful in establishing diagnosis in the early stages of ischemia, before necrosis develops.

          Methods and Results

          30 patients that underwent only coronary bypass surgery due to ischemic heart disease within a specific period of time have been included in the study. IMA levels were studied in the preoperative, intraoperative, and postoperative periods. The albumin cobalt binding assay was used for IMA determination. Hemodynamic parameters (atrial fibrillation, the need for inotropic support, ventricular arrhythmia) of the patients in the postoperative stage were evaluated. Intraoperative measurement values (mean ± SD) of IMA (0.67677 ± 0.09985) were statistically significantly higher than those in the preoperative (0.81516 ± 0.08894) and postoperative (0.70477 ± 0.07523) measurements. Considering atrial fibrillation and need for inotropics, a parallelism was detected with the levels of IMA.

          Conclusions

          IMA is an early-rising marker of cardiac ischemia and enables providing a direction for the treatment at early phases.

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          Most cited references30

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          Universal definition of myocardial infarction.

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            A novel assay for cobalt-albumin binding and its potential as a marker for myocardial ischemia-a preliminary report.

            We initially observed a phenomenon of reduced in vitro binding of exogenous cobalt [Co(II)] to the N-terminus of human serum albumin (HSA) in emergency chest pain patients with early onset unstable angina and myocardial infarction. We then developed a colorimetric assay to measure cobalt-HSA binding and record the results in absorbance units (ABSU). In a preliminary clinical study of 139 emergency patients with acute chest pain, 99 patients with evidence of myocardial ischemia (Group 1) had elevated assay levels (mean ABSU +/- SD; 0.519 +/- 0.086) compared to 40 patients (Group 2) with no evidence of ischemia (0.316 +/- 0.092) (p < 0.00001). In Group 1, 95 of 99 (96.0%) patients had levels higher than a decision threshold of 0.400 ABSU and in Group 2, 37 of 40 (92.5%) samples had higher cobalt binding capacity (ABSU
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              Role of reactive oxygen species on the formation of the novel diagnostic marker ischaemia modified albumin.

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                Author and article information

                Journal
                J Cardiothorac Surg
                J Cardiothorac Surg
                Journal of Cardiothoracic Surgery
                BioMed Central
                1749-8090
                2012
                5 January 2012
                : 7
                : 3
                Affiliations
                [1 ]Kocaeli University Medical Faculty Department of Cardiovascular Surgery; 41380; Kocaeli, Turkey
                [2 ]Canakkale Onsekiz Mart University Medical Faculty Department of Biochemistry; 17100, Canakkale, Turkey
                [3 ]Kocaeli University Medical Faculty Department of Anaesthesiology; 41380, Kocaeli, Turkey
                Article
                1749-8090-7-3
                10.1186/1749-8090-7-3
                3398305
                22221979
                9f88b98b-1bef-4242-bbf0-7c29afcc0ce2
                Copyright ©2012 Kanko et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 2 September 2011
                : 5 January 2012
                Categories
                Research Article

                Surgery
                coronary artery bypass surgery,myocardial ischaemia,ischemia-modified albumine
                Surgery
                coronary artery bypass surgery, myocardial ischaemia, ischemia-modified albumine

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