Ischemia modified albumin: a potent marker in acute myocardial infarction in normolipidaemic

ABSTRACT

Currently, there are no well-defined biochemical markers for identification of myocardial ischemia in normolipidaemic AMI individuals. Biochemical markers such as CK-MB, cTnl and myoglobin, used in assessing cellular necrosis, are not suitable for assessing myocardial ischemia.The introduction of the Ischemia Modified Albumin [IMA] assay for the first time provides emergency physicians with an objective diagnostic study to determine the presence of myocardial ischemia completely within the control of the emergency department. The present study was planned to evaluate IMA concentration in myocardial infarction patients with normal lipid profile. The serum IMA levels were determined in 165 normolipademic MI patients and 165 age-sexes matched healthy volunteers served as control. The levels of IMA were determined by addition of known amount of Cobalt [II] to a serum specimen and measurement of the unbound cobalt [II] by colorimetric assay using dithiothreitol [DTT]. Lipid profile was also analyzed enzymatically in these subjects. The values were expressed as means +/- standard deviation [SD] and data from patients and control was compared using student's 't'-test. Serum IMA levels were significantly increased in Ml patients as compared to control [p<0.001]. Also total cholesterol, TC HDL-C ratio, triglycerides, LDL-cholesterol, LDL-C HDL-C ratio and TG HDL-C ratio were higher in AMI subjects [pc0.001] and HDL-cholesterol were lower in MI patients [p<0.001]. IMA can be used as an alternative biochemical parameter to aid clinical diagnosis which is cost effective