Second Department of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece.
J Clin Lab Anal. 2010;24(6):399-402. doi: 10.1002/jcla.20418.
Acute aortic dissection (AOD) is associated with high mortality and early diagnosis and treatment are essential. Ischemia-modified albumin (IMA) is a marker of myocardial ischemia whereas cardiac enzymes are released when myocardial necrosis occurs. We investigated, for the first time, whether IMA increases in AOD either at presentation or after surgery.
We studied 46 consecutive patients with documented AOD; we also evaluated 13 consecutive patients with dilated ascending aortas scheduled for elective surgery and admitted for preoperative coronary angiography; 46 age-matched normal subjects served as controls. Only patients with acute onset of symptoms were included. We evaluated IMA, cardiac enzymes, N-terminal pro-B-type natriuretic peptide, albumin, C-reactive protein (CRP), and D-dimers on admission, 24 hr post-operatively and 4 days post-operatively. Duration from symptom onset to the first sample was 23±17 hr.
IMA did not differ between patients with AOD at presentation (93±19 U/ml), patients with chronic aneurysms (90±14 U/ml) and normal controls (91±9 U/ml). In addition, IMA did not change significantly after surgical repair. IMA, at baseline, however, correlated positively with time from symptom onset as well as CRP levels (P=0.05 and P=0.007, respectively).
IMA is not elevated in AOD when blood sampling is performed within 23±17 hr after symptom onset nor increases after surgery.
急性主动脉夹层（AOD）与高死亡率相关，早期诊断和治疗至关重要。缺血修饰白蛋白（IMA）是心肌缺血的标志物，而心肌坏死时会释放心肌酶。我们首次研究了在 AOD 发病时或手术后 IMA 是否会增加。
我们研究了 46 例经证实的 AOD 连续患者；我们还评估了 13 例连续患有扩张性升主动脉并计划进行择期手术且因术前冠状动脉造影而入院的患者；46 名年龄匹配的正常受试者作为对照。仅包括有急性症状发作的患者。我们在入院时、术后 24 小时和术后 4 天评估 IMA、心肌酶、N 端脑利钠肽前体、白蛋白、C 反应蛋白（CRP）和 D-二聚体。从症状发作到第一次取样的时间为 23±17 小时。
AOD 患者就诊时的 IMA （93±19 U/ml）、慢性动脉瘤患者（90±14 U/ml）和正常对照组（91±9 U/ml）之间无差异。此外，手术后 IMA 变化不明显。然而，IMA 在基线时与症状发作时间以及 CRP 水平呈正相关（P=0.05 和 P=0.007，分别）。
在症状发作后 23±17 小时内采血时，AOD 中 IMA 并未升高，手术后也不会升高。
