Sinha Manas K, Gaze David C, Tippins John R, Collinson Paul O, Kaski Juan Carlos
Coronary Artery Disease Research Unit, St George's Hospital, London, UK.
Circulation. 2003 May 20;107(19):2403-5. doi: 10.1161/01.CIR.0000072764.18315.6B. Epub 2003 May 12.
Ischemia modified albumin (IMA; Ischemia Technologies, Inc) blood levels rise in patients who develop ischemia during percutaneous coronary intervention (PCI). It is not known whether IMA elevations correlate with increases in other markers of oxidative stress, ie, 8-iso prostaglandin F2-A (iP).
We compared IMA versus iP plasma levels in 19 patients (mean age 62.8+/-11.9 years) undergoing PCI and 11 patients (mean age 64+/-13.6 years) undergoing diagnostic angiography (controls). In the PCI patients, blood samples for IMA and iP were taken from the guide catheter before PCI and after balloon inflations, and from the femoral sheath 30 minutes after PCI. IMA was measured by the albumin cobalt binding (ACB) test and plasma iP by enzyme immunoassay. During PCI, all 19 patients had chest pain and 18 had transient ischemic ST segment changes. IMA was elevated from baseline in 18 of the 19 patients after PCI. Median IMA levels were higher after PCI (101.4 U/mL, 95%CI 82 to 116) compared with baseline (72.8 U/mL, CI 55 to 93; P<0.0001). Levels remained elevated at 30 minutes (87.9 U/mL, CI 78 to 99; P<0.0001) and returned to baseline at 12 hours (70.3 U/mL, CI 65 to 87; P=0.65). iP levels were raised after PCI in 9 of the 19 patients. However, median iP levels were not significantly different immediately (P=0.6) or 30 minutes after PCI (P=0.1). In the control group, IMA and iP levels remained unchanged before and after angiography (P=0.2 and 0.16, respectively).
IMA is a more consistent marker of ischemia than iP in patients who develop chest pain and ST segment changes during PCI.
在经皮冠状动脉介入治疗（PCI）过程中发生缺血的患者，其缺血修饰白蛋白（IMA；缺血技术公司）的血液水平会升高。目前尚不清楚IMA升高是否与其他氧化应激标志物（即8-异前列腺素F2 - A，iP）的升高相关。
我们比较了19例接受PCI治疗的患者（平均年龄62.8±11.9岁）和11例接受诊断性血管造影的患者（平均年龄64±13.6岁，作为对照组）的IMA与iP血浆水平。对于接受PCI治疗的患者，在PCI术前、球囊扩张后以及PCI术后30分钟从引导导管采集用于检测IMA和iP的血样，并从股动脉鞘采集血样。通过白蛋白钴结合（ACB）试验测量IMA，通过酶免疫测定法测量血浆iP。在PCI过程中，所有19例患者均出现胸痛，18例有短暂性缺血性ST段改变。19例患者中有18例在PCI术后IMA水平较基线升高。与基线水平（72.8 U/mL，可信区间55至93；P<0.0001）相比，PCI术后IMA中位数水平更高（101.4 U/mL，95%可信区间82至116）。30分钟时水平仍升高（87.9 U/mL，可信区间78至99；P<0.0001），并在12小时时恢复至基线水平（70.3 U/mL，可信区间65至87；P = 0.65）。19例患者中有9例在PCI术后iP水平升高。然而，PCI术后即刻（P = 0.6）和30分钟时iP中位数水平无显著差异（P = 0.1）。在对照组中，血管造影术前和术后IMA和iP水平均无变化（分别为P = 0.2和0.16）。
在PCI过程中出现胸痛和ST段改变的患者中，IMA是比iP更一致地反映缺血的标志物。
