Prognostic significance of ischemia modified albumin after percutaneous coronary intervention.

UNLABELLED: Ischemia modified albumin (IMA) is a new biochemical marker of ischemia. IMA levels rise in patients who develop ischemia during percutaneous coronary intervention (PCI). It is unclear whether IMA elevations correlate with PCI variables. The possible prognostic value of post-PCI IMA elevation has not yet to be studied. METHODS: We studied 60 patients (mean age 61 years; 51 male) who underwent successful elective single-vessel PCI for the management of stable angina pectoris. IMA levels were measured and compared with PCI variables and target lesion revascularization rate. The median post-PCI follow up is 46 months (CI 44.6 to 47.7). RESULTS: We found that the only variable related to post-PCI IMA levels was periprocedural dissection of target vessel (147.6 vs. 141.1 kU/l, p=0.035). No correlation between high and low balloon inflation pressure (143.6 vs. 141.6 kU/l, p=0.64), short and long inflation pressure (141.5 vs. 143.6 kU/l, p=0.17), with and without stent placement (143.7 vs. 141.3 kU/l, p=0.93) was found. IMA level more then 130 kU/l was associated with higher frequency of target lesion revascularization at nearly 4-years follow-up (p=0.026). CONCLUSION: Post-PCI IMA elevation is associated with higher target lesion revascularization.

Fluorometric assay of lipoperoxides and chromatographic analysis of alpha-tocopherol and fatty acids as biomarkers of risk from coronary atherosclerosis.

There has been growing interest in the quantitative determination of biochemical predictors of atherogenesis. The aim of the present study was to investigate association of lipoperoxidation biomarkers known to be pro-atherogenic (thiobarbituric acid reactive substance activity, TBARS) or anti-atherogenic (alpha-tocopherol) with the fatty acid status, and relate it to the coronary artery disease (CAD) as assessed by coronary angiography in patients with stable angina pectoris. We found that serum lipoproteins and TBARS did not differ significantly. However there was significant correlation of TBARS with total vitamin E (P=0.02) and vitamin E in very low-density lipoprotein (VLDL) (P=0.02) and low-density lipoprotein (LDL) (P=0.01), with LDL-linoleic acid (P=0.01), and high-density lipoprotein-linoleic acid (P=0.02). There was significant correlation of total vitamin E (P=0.01) and VLDL-vitamin E (P=0.01) with the degree of CAD. We conclude that TBARS and alpha-tocopherol could not be evaluated as biomarkers for the severity of CAD among the patients with stable angina pectoris.