Ischemia modified Albumin : A concept molecule for rapid diagnosis of ischemia
Posted Sep 04 2010 8:28am
In the diagnosis of ACS, we have definite bio markers for acute MI . Further, ECG has a good spcecificity for STEMI . While ,clinical and ECG features of ischemia are not perfect. A bio marker for ischemia is the ultimate dream of cardiologists and emergency room physicians. . In this context , the IMA -ischemia modifed albumin has come with great expectation .
Ischemia modifies what ?
Normal albumin moleule has a metal binding site (Copper ) .There are few free binding sites available .During ischemia this metal binding capacity reduces . A cobalt containing reagent when added to ischemic blood finds binding sites scarce , and hence excess free cobalt will color the sample and a posiitve test for ischemia is diagnosed.
*Normal human albumin may contain 2% of ischmia modifed albumin which is expected to increase up to 6% during ischemia
IMA raises not only during ischemia it can also raise during oxidative stress
Chronic kidney disease
It can also be elevated following
Routine coronary angiogram
Increased lactic acid for example in sepsis may reduce the IMA level and can miss an episode of true ischemia
IMA can be a useful tool to identify ischemia early .But lacks senstiivty . New improved immunoassays may be more sensitive and specific