Chek James, Dusek Jaroslav, Stasek Josef, Vojacek Jan, Bis Josef, Ulrychova Martina, Tichy Milos, Tomko Tomas, Bukac Josef
First Department of Internal Medicine, University Hospital Hradec Králové, Charles University in Prague, Faculty of Medicine in Hradec Králové, Czech Republic.
Heart Vessels. 2011 Nov;26(6):622-7. doi: 10.1007/s00380-010-0114-0. Epub 2011 Jan 26.
Ischemia-modified albumin (IMA) is a laboratory biomarker of cardiac ischemia. Our study aims to determine whether IMA can estimate or represent to any degree the extent of myocardial ischemia. We expect that the higher the marker of cardiac necrosis (maximum value after serial measurements) the greater the preceding cardiac ischemia, indicated by IMA in patients diagnosed with STEMI prior to direct percutaneous coronary intervention (PCI). We studied 216 patients indicated for direct PCI with a diagnosis of ST elevation myocardial infarction. Biochemical analysis of IMA was carried out using the albumin cobalt binding (ACB®) test. We also obtained relevant values for markers of myocardial necrosis (CK, CK-MB, cTnT). In all patients, there was an increased level of IMA prior to the procedure (116 ± 16.9 kU/l); also raised were levels of CK (17.32 μkat/l), CK-MB (4.85 μkat/l) and cTnT (2.97 μg/l) taken as the maximum values obtained after serial measurements at 12, 18, and 24 h after the procedure. We observed that there was no significant association between increase in IMA and cTnT (R2 = 0.0068, p = 0.483). This was also the case for CK-MB (R2 = 0.0011, p = 0.637). IMA does not estimate the extent of ischemia in patients with ST elevation myocardial infarction. However, its absence can be used qualitatively to rule out cardiac ischemia.
缺血修饰白蛋白（IMA）是心脏缺血的一种实验室生物标志物。我们的研究旨在确定IMA是否能够在任何程度上估计或代表心肌缺血的程度。我们预计，对于在直接经皮冠状动脉介入治疗（PCI）前被诊断为ST段抬高型心肌梗死（STEMI）的患者，心脏坏死标志物（连续测量后的最大值）越高，先前的心脏缺血程度就越高，这由IMA表示。我们研究了216例被指定进行直接PCI且诊断为ST段抬高型心肌梗死的患者。使用白蛋白钴结合（ACB®）试验对IMA进行生化分析。我们还获得了心肌坏死标志物（CK、CK-MB、cTnT）的相关值。在所有患者中，术前IMA水平升高（116±16.9 kU/l）；作为术后12、18和24小时连续测量获得的最大值，CK（17.32 μkat/l）、CK-MB（4.85 μkat/l）和cTnT（2.97 μg/l）水平也升高。我们观察到IMA升高与cTnT之间无显著相关性（R2 = 0.0068，p = 0.483）。CK-MB也是如此（R2 = 0.0011，p = 0.637）。IMA不能估计ST段抬高型心肌梗死患者的缺血程度。然而，其缺乏可用于定性排除心脏缺血。
