Evaluation of Human Serum Albumin Cobalt Binding Assay for the Assessment of Myocardial Ischemia and Myocardial Infarction

Bhagavan, N.V.; Lai, Ernest; Ríos, Patricia; Yang, Jinsheng; Ortega-Lopez, Anna M.; Shinoda, Hiroko; Honda, Stacey; Rios, Carlos N.; Sugiyama, Cheryl E.; Ha, Chung-Eun

doi:10.1373/49.4.581

Cited by 235 publications

(175 citation statements)

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“…There are several sites on the protein that have the ability to bind metals, though most interest to date has focused on the N-terminal region. 13,18 IMA was determined according to the cobalt-binding assay method of Bhagavan et al 13 Briefly, plasma was incubated with a cobalt chloride (1 g/L, 10 minutes) and dithiothreitol (1.5 g/L, 2 minutes) before dilution in saline prior to measurement at 470 nm in a spectrophotometer (Agilent 8453 Diode Array, Agilent, UK). IMA was calculated from the difference between samples measured with and without dithiothreitol.…”

Section: Measurement Of Albumin Functionmentioning

confidence: 99%

“…Electron paramagnetic resonance (EPR) spectroscopy was used to perform detailed analyses of the individual binding sites that are associated with the main function of albumin. Ischemia-modified albumin, 13 a test that measures the cobalt-binding capacity of albumin, was measured in the same cohort to determine whether this simpler test could be used as a biomarker to determine prognosis in patients with acute-on-chronic liver failure (ACLF). In addition, we wanted to determine whether dialysis against an albumin solution using the MARS system has any ability to affect albumin functional capacity in patients with ACLF.…”

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confidence: 99%

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Alterations in the functional capacity of albumin in patients with decompensated cirrhosis is associated with increased mortality

Schnurr²,

et al. 2009

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Albumin concentration is diminished in patients with liver failure. Albumin infusion improves survival of cirrhotic patients with spontaneous bacterial peritonitis, and it is hypothesized that this may be due in part to its detoxifying capabilities. The aim of this study was to perform detailed quantitative and qualitative assessment of albumin function in patients with cirrhosis. Healthy controls and patients with acute deterioration of cirrhosis requiring hospital admission (n ‫؍‬ 34) were included. Albumin function was assessed using affinity of the fatty acid binding sites using a spin label (16 doxyl-stearate) titration and electron paramagnetic resonance spectroscopy and ischemia-modified albumin (IMA) was measured. Twenty-two patients developed acute-on-chronic liver failure. Twelve were treated with the Molecular Adsorbents Recirculating System (MARS) and 10 with standard medical therapy. For each parameter measured, the patients' albumin had reduced functional ability, which worsened with disease severity. Fifteen patients died, and IMA, expressed as an albumin ratio (IMAR), was significantly higher in nonsurvivors compared with survivors (P < 0.001; area under the receiver operating curve ‫؍‬ A lbumin is the major plasma protein and constitutes around 50% of the cell free protein in healthy individuals. It is produced exclusively in the liver, and therefore its concentration is reduced during hepatic dysfunction. 1 Following the Cochrane meta-analysis describing potential harmfully effect of albumin infusion in critically ill patients, there has been a reexamination of the use of albumin infusions for volume replacement. However, the results of the recently published SAFE study have provided new data confirming the safety of albumin infusion in critically ill patients. 2,3 Liver failure results in multiple organ dysfunction, and mortality rates without liver transplantation remain unacceptably high. 4 However, recovery is associated with complete reversal of multiorgan dysfunction. At present, in patients with cirrhosis, albumin is used mainly to replenish the circulating volume. With increasing severity of cirrhosis, there is a progressive increase in cardiac output, which is associated with a progressive reduction in individual organ blood flow. This peculiar circulatory disturbance is thought to occur as a result of splanchnic

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Section: Measurement Of Albumin Functionmentioning

confidence: 99%

mentioning

confidence: 99%

Alterations in the functional capacity of albumin in patients with decompensated cirrhosis is associated with increased mortality

Schnurr²,

et al. 2009

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“…We evaluated the role of ischemia-modified albumin (IMA), a new marker of ischemia, in patients with ACS. IMA is produced during an ischemic attack and is present in blood in easily detectable concentrations (12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

Assay of ischemia‐modified albumin and C‐reactive protein for early diagnosis of acute coronary syndromes

Liyan

Zhang

Yong-hua

et al. 2008

Clinical Laboratory Analysis

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Diagnosis of cardiac ischemia in patients coming to emergency departments (ED) with symptoms of acute chest pain is often difficult. Many markers are sensitive and specific for the detection of myocardial necrosis but may not rise during reversible myocardial ischemia. Ischemia-modified albumin (IMA) has recently been shown to be a sensitive and early biochemical marker of ischemia. The variation laws were observed by measuring IMA and C-reactive protein (CRP) of 113 patients in ED within 12 hr after onset of chest pain. In the observation, blood was taken for IMA and CRP. Patients underwent standardized triage, diagnostic procedures, and treatment. Results of IMA and CRP were correlated with final diagnoses of nonischemic chest pain (NICP) and acute coronary syndrome (ACS). There were obvious distinction of IMA and CRP levels between the NICP and ACS groups. Receiver operator characteristic (ROC) curve analysis was used to determine the optimal cutoff of this assay for identifying individuals with ACS patients from NICP. The area under the curves of IMA is 0.948. The sensitivity and specificity of albumin cobalt binding (ACB) at a cutoff value of 70.0 units/mL were 94.4% and 82.6%, respectively. The area under the curves of CRP is 0.746. Sensitivity and specificity of CRP at a cutoff value of 3.16 mg/L were 70.0% and 73.9%, respectively. Negative predictive value (NPV) of IMA and CRP for ischemia origin was 79.2% and 38.6%, respectively. IMA may make an early diagnosis of acute coronary ischemia, and will improve the early diagnostic sensitivity and specificity of ACS.

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“…This alteration can be measured by the albumin cobalt-binding (ACB) test. 23,24 Several studies have shown that IMA is an early sensitive marker for the diagnosis of reversible ischemia. 25,26 However, a recent study found frequent false-positive results and a low specificity with this test.…”

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confidence: 99%

Clinical Assessment of Ischemia‐modified Albumin and Heart Fatty Acid–binding Protein in the Early Diagnosis of Non‐ST‐elevation Acute Coronary Syndrome in the Emergency Department

Charpentier

Ducassé

Cournot

et al. 2010

Academic Emergency Medicine

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Objectives: Heart fatty acid-binding protein (h-FABP) and ischemia-modified albumin (IMA) have recently been evaluated, but to the best of our knowledge, no study has reported an analysis of these two markers for the detection of early myocardial infarction and myocardial ischemia in a large cohort of consecutive patients presenting to an emergency department (ED). This study evaluates the diagnostic accuracy and the clinical utility of h-FABP and IMA for non-ST-segment elevation acute coronary syndrome (ACS) diagnosis in the first hour of management in an ED.Methods: In a prospective 11-month study, 677 patients admitted to the ED with chest pain and suspected non-ST-segment elevation ACS were enrolled. On presentation, blood samples were obtained for the measurement of the biomarkers h-FABP (immunodetection with CardioDetect) and IMA (albumin cobalt-binding test). Two physicians, blinded to the results of the markers, independently categorized patients as having or not having non-ST-segment elevation ACS.Results: Of the 677 patients who were prospectively recruited, non-ST-segment elevation ACS was diagnosed in 185 (27.3%). While IMA was not predictive of the ACS diagnosis (odds ratio [OR] = 1.23; 95% CI = 0.87 to 1.81), h-FABP was predictive of ACS diagnosis (OR = 4.65; 95% CI = 2.39 to 9.04) with specificity at 96.8% (95% CI = 95.4% to 98.1%) and sensitivity at 13.5% (95% CI = 10.9% to 16.1%). However, h-FABP did not add significant additional information to a predictive model that included the usual diagnostic tools for non-ST-elevation ACS management (p = 0.40). Conclusions:In this study on a large cohort of patients admitted to an ED for chest pain, IMA and h-FABP did not provide valuable information for ACS diagnosis.

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Evaluation of Human Serum Albumin Cobalt Binding Assay for the Assessment of Myocardial Ischemia and Myocardial Infarction

Cited by 235 publications

References 13 publications

Alterations in the functional capacity of albumin in patients with decompensated cirrhosis is associated with increased mortality

Alterations in the functional capacity of albumin in patients with decompensated cirrhosis is associated with increased mortality

Assay of ischemia‐modified albumin and C‐reactive protein for early diagnosis of acute coronary syndromes

Clinical Assessment of Ischemia‐modified Albumin and Heart Fatty Acid–binding Protein in the Early Diagnosis of Non‐ST‐elevation Acute Coronary Syndrome in the Emergency Department

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