Ischemia-modified albumin (IMA) is not useful for detecting myocardial ischemia during symptom-limited exercise stress tests

Abstract

Background/Aims: We examined the ischemia-modified albumin (IMA) level during exercise in patients with coronary artery disease (CAD).Methods: Forty patients with a history of chest pain underwent both symptom-limited treadmill exercise stress testing and coronary angiography within one week. During the treadmill tests, blood samples were obtained at baseline and 5 min after exercise to measure the serum IMA level.Results: Of the 40 patients, fourteen (35%, CAD group) had significant coronary artery stenosis, while the other 26 (65%, non-CAD group) did not. The baseline and post-exercise IMA levels in the two groups did not differ significantly (105.2±7.2 vs. 107.7±6.7 U/mL at baseline and 93.1±10.1 vs. 94.8±5.7 U/mL at post-exercise in the CAD and non-CAD groups, p=0.29 and 0.57, respectively). The changes in IMA after exercise did not differ either (-10.4±7.5 vs. -14.0±7.6 U/mL in the CAD and non-CAD groups, respectively, p=0.10). Similarly, the change in IMA between the exercise ECG test positive (TMT positive, n=9) and negative (TMT negative, n=20) groups did not differ (-14.63±5.19, vs -8.50±9.01 U/mL, p=0.15, in the TMT positive and negative groups, respectively).Conclusions: Our results suggest that IMA has limitation in detecting myocardial ischemia during symptom-limited exercise stress tests.

The effect of effort test on the levels of ischemia modified albumin, 7-ketocholesterol and cholestan-3β , 5α , 6β -triol and their role in the diagnosis of coronary artery disease

“…This finding is in contrast with the majority of data in the literature (26, 27, 28, 29). However, there are also studies in which no significant difference was found for IMA in similarly arranged groups, which is in parallel with our results (30, 31). We believe that these differences may suggest that IMA levels could vary with factors such as, the duration of the effort test, the amount of vascular occlusion and the severity of coronary artery disease.…”

Combinatorial Determination of Ischemia Modified Albumin and Protein Carbonyl in the Diagnosis of NonST-Elevation Myocardial Infarction

“…However, the area under curve of ROC curve of IMA was not good enough and might not be a good candidate for diagnosis of myocardial infarction. The lack of diagnostic potential of IMA was also mentioned in many studies [1,21,22]. However, our results showed that combinatorial determination of these two biomarkers gave not good enough for NSTEMI diagnosis as it, although it slightly increased NPV and test efficiency.…”

Investigation of serum vitamin D and ischaemia‐modified albumin levels in infertile Turkish men

“…Although the mechanism of the formation of ischaemia‐modified albumin (IMA) is not fully understood, it is postulated that IMA is produced as a result of a change in the N‐terminal structure of albumin as a result of a series of biochemical reactions triggered by oxygen deficiency (Kim et al, ). Serum IMA levels have been a useful biomarker for monitoring ischaemic and infectious events, type 2 diabetes mellitus, chronic hepatitis C and pulmonary embolism.…”