Health knowledge made personal
Join this community!
› Share page:
Go
Search posts:

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

  1. Stroke, 
  2. Chronic kidney disease 
  3. liver disease,
  4. Maligancy

It can also  be elevated following

  • Routine coronary angiogram
  • PCI
  • DC shock

Increased lactic acid for example in sepsis may reduce the IMA level and can miss an episode of true ischemia

Final message

IMA can be a useful tool to identify  ischemia early .But lacks senstiivty . New improved immunoassays may be more sensitive and specific

Reference

1 . Medscape review  

2. Circulation article

3. PRIMA study which  was done in ER in risk stratifying ACS proved IMA is not vey useful  http://emj.bmj.com/content/23/10/764.abstract


Post a comment
Write a comment:

Related Searches