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İskemi modifiye albümin düzeylerinin NSTEMI hastalarını iskemik olmayan kontrollerden ayırt etmedeki rolü ve hastalık şiddeti ile ilişkisi

Year 2021, Volume: 46 Issue: 4, 1566 - 1573, 30.12.2021
https://doi.org/10.17826/cumj.976875

Abstract

Amaç: Bu çalışmada yüksek duyarlılığa sahip kardiyak troponin (hs-cTn) testleri ile tanı konulan erken dönem ST yükselmesiz miyokard infarktüsü (NSTEMI) hastalarında iskemi modifiye albümin (İMA) 'nın tanısal değerini araştırmayı amaçladık.
Gereç ve Yöntem: Mart 2018 ve Ağustos 2019 tarihleri arasında hastanemize NSTEMI ile başvuran kardiyovasküler hastalık öyküsü olmayan 126 hasta kaydedildi. Hastaların IMA düzeyleri rastgele seçilen, yaş ve cinsiyet eşleştirilmiş koroner anjiyografi sonuçları normal olan 61 deneğin IMA düzeyleri ile karşılaştırıldı.
Bulgular: NSTEMI hastalarının IMA seviyeleri kontrol grubuna göre daha yüksekti. İşlem karakteristiği (ROC) eğri analizinde, 0,3855 ABSU' ya eşit veya daha büyük bir değer, NSTEMI tanısı için %82 duyarlılığa ve%99,4 özgülüğe sahiptir (EAA: 0,962, %95 CI: 0,937 – 0,986). Ek olarak, ROC eğrisi analizi, üç damar hastalığını ayırt etmek için orta düzeyde tahmin gücü ortaya koydu (sınır değeri: 0,4290 ABSU, duyarlılık %78,4 ve özgüllük %56,3, EAA: 0,696, %95 CI: 0,616 – 0,776). İMA düzeyleri ile hasta grubunun Gensini puanları arasında pozitif korelasyon vardı.
Sonuç: İskemi modifiye albümin tek başına kullanıldığında, NSTEMI' yi iskemik olmayan kontrollerden ayırt etmede oldukça yararlı olmuştur. Ayrıca, IMA seviyeleri KAH şiddeti ile pozitif korelasyon gösteriyordu.

References

  • 1. Puymirat E, Simon T, Cayla G, Cottin Y, Elbaz M, Coste P, et al. Acute Myocardial Infarction: Changes in Patient Characteristics, Management, and 6-Month Outcomes Over a Period of 20 Years in the FAST-MI Program (French Registry of Acute ST-Elevation or Non-ST-Elevation Myocardial Infarction) 1995 to 2015. Circulation 2017; 136(20): 1908-19. 2017/08/29.
  • 2. Twerenbold R, Badertscher P, Boeddinghaus J, Nestelberger T, Wildi K, Puelacher C, et al. 0/1-Hour Triage Algorithm for Myocardial Infarction in Patients With Renal Dysfunction. Circulation 2018; 137(5): 436-51. 2017/11/05.
  • 3. Boeddinghaus J, Twerenbold R, Nestelberger T, Koechlin L, Wussler D, Meier M, et al. Clinical Use of a New High-Sensitivity Cardiac Troponin I Assay in Patients with Suspected Myocardial Infarction. Clin Chem 2019; 65(11): 1426-36. 2019/10/02. doi: 10.1373/clinchem.2019.304725.
  • 4. Collet JP, Thiele H, Barbato E, Barthelemy O, Bauersachs J, Bhatt DL, et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. European heart journal 2020. 2020/08/30. 5. Sbarouni E, Georgiadou P, Voudris V. Ischemia modified albumin changes – review and clinical implications. Clinical Chemistry and Laboratory Medicine (CCLM) 2011; 49(2): 177.
  • 6. Collinson PO, Gaze DC. Biomarkers of cardiovascular damage and dysfunction--an overview. Heart, lung & circulation 2007; 16 Suppl 3: S71-82. 2007/07/10.
  • 7. Keating L, Benger JR, Beetham R, Bateman S, Veysey S, Kendall J, et al. The PRIMA study: presentation ischaemia-modified albumin in the emergency department. Emerg Med J 2006; 23(10): 764-8. 2006/09/22.
  • 8. Hjortshoj S, Kristensen SR, Ravkilde J. Diagnostic value of ischemia-modified albumin in patients with suspected acute coronary syndrome. The American journal of emergency medicine 2010; 28(2): 170-6. 2010/02/18. doi: 10.1016/j.ajem.2008.10.038.
  • 9. Christenson RH, Duh SH, Sanhai WR, Wu AH, Holtman V, Painter P, et al. Characteristics of an Albumin Cobalt Binding Test for assessment of acute coronary syndrome patients: a multicenter study. Clin Chem 2001; 47(3): 464-70. 2001/03/10.
  • 10. Peacock F, Morris DL, Anwaruddin S, Christenson RH, Collinson PO, Goodacre SW, et al. Meta-analysis of ischemia-modified albumin to rule out acute coronary syndromes in the emergency department. Am Heart J 2006; 152(2): 253-62. 2006/08/01.
  • 11. Sinha MK, Roy D, Gaze DC, Collinson PO, Kaski JC. Role of "Ischemia modified albumin", a new biochemical marker of myocardial ischaemia, in the early diagnosis of acute coronary syndromes. Emerg Med J 2004; 21(1): 29-34. 2004/01/22.
  • 12. Koc F, Erdem S, Altunkas F, Ozbek K, Gul EE, Kurban S, et al. Ischemia-modified albumin and total antioxidant status in patients with slow coronary flow: a pilot observational study. Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology 2011; 11(7): 582-7. 2011/09/14.
  • 13. Lippi G, Ferrari A, Gandini G, Gelati M, Lo Cascio C, Salvagno GL. Analytical evaluation of the new Beckman Coulter Access high sensitivity cardiac troponin I immunoassay. Clin Chem Lab Med 2017; 56(1): 157-61. 2017/07/14.
  • 14. Roffi M, Patrono C, Collet JP, Mueller C, Valgimigli M, Andreotti F, et al. 2015 ESC Guidelines for the Management of Acute Coronary Syndromes in Patients Presenting Without Persistent ST-segment Elevation. Rev Esp Cardiol (Engl Ed) 2015; 68(12): 1125. 2015/12/18.
  • 15. Bar–Or D, Lau E, Winkler JV. A novel assay for cobalt-albumin binding and its potential as a marker for myocardial ischemia—a preliminary report11Original Contributions is coordinated by John A. Marx, MD, of Carolinas Medical Center, Charlotte, North Carolina. The Journal of Emergency Medicine 2000; 19(4): 311-15.
  • 16. Hosmer DW, Lemeshow S. Applied logistic regression. New York: Wiley; 2008.
  • 17. Chek J, Dusek J, Stasek J, Vojacek J, Bis J, Ulrychova M, et al. Role of ischemia-modified albumin in estimating the extent and scope of cardiac ischemia in patients with ST elevation myocardial infarction. Heart and vessels 2011; 26(6): 622-7. 2011/01/27.
  • 18. Dominguez-Rodriguez A, Abreu-Gonzalez P, Garcia-Gonzalez MJ, Samimi-Fard S, Kaski JC. Relation of ischemia-modified albumin levels and left ventricular systolic function in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. Clinica chimica acta; international journal of clinical chemistry 2008; 388(1-2): 196-99.
  • 19. Bali L, Cuisset T, Giorgi R, Monserrat C, Quilici J, Carrega L, et al. Prognostic value of ischaemia-modified albumin in patients with non-ST-segment elevation acute coronary syndromes. Arch Cardiovasc Dis 2008; 101(10): 645-51. 2008/12/06.
  • 20. Bhagavan NV, Lai EM, Rios PA, Yang J, Ortega-Lopez AM, Shinoda H, et al. Evaluation of human serum albumin cobalt binding assay for the assessment of myocardial ischemia and myocardial infarction. Clin Chem 2003; 49(4): 581-5. 2003/03/26.
  • 21. Roy D, Quiles J, Aldama G, Sinha M, Avanzas P, Arroyo-Espliguero R, et al. Ischemia Modified Albumin for the assessment of patients presenting to the emergency department with acute chest pain but normal or non-diagnostic 12-lead electrocardiograms and negative cardiac troponin T. Int J Cardiol 2004; 97(2): 297-301. 2004/10/02.
  • 22. Collinson PO, Gaze DC, Bainbridge K, Morris F, Morris B, Price A, et al. Utility of admission cardiac troponin and "Ischemia Modified Albumin" measurements for rapid evaluation and rule out of suspected acute myocardial infarction in the emergency department. Emergency medicine journal : EMJ 2006; 23(4): 256-61.
  • 23. Anwaruddin S, Januzzi JL, Jr., Baggish AL, Lewandrowski EL, Lewandrowski KB. Ischemia-modified albumin improves the usefulness of standard cardiac biomarkers for the diagnosis of myocardial ischemia in the emergency department setting. Am J Clin Pathol 2005; 123(1): 140-5. 2005/03/15.
  • 24. Demirtas AO, Karabag T, Demirtas D. Ischemic Modified Albumin Predicts Critical Coronary Artery Disease in Unstable Angina Pectoris and Non-ST-Elevation Myocardial Infarction. J Clin Med Res 2018; 10(7): 570-75. 2018/06/16.
  • 25. Duarte MM, Rocha JB, Moresco RN, Duarte T, Da Cruz IB, Loro VL, et al. Association between ischemia-modified albumin, lipids and inflammation biomarkers in patients with hypercholesterolemia. Clinical biochemistry 2009; 42(7-8): 666-71. 2009/03/26.
  • 26. Piwowar A, Knapik-Kordecka M, Warwas M. Ischemia-modified albumin level in type 2 diabetes mellitus - Preliminary report. Disease markers 2008; 24(6): 311-7. 2008/08/09.
  • 27. Baydin A, Amanvermez R, Tuncel Ö K, Ocak M, Meric M, Cokluk C. Ischemia-modified albumin is not better than creatine kinase-MB and cardiac troponin I in predicting a cardiac injury in nontraumatic subarachnoid hemorrhage. The American journal of emergency medicine 2015; 33(4): 488-92. 2015/03/07.
  • 28. Sbarouni E, Georgiadou P, Panagiotakos D, Livanis EG, Theodorakis GN, Kremastinos DT. Ischaemia modified albumin in radiofrequency catheter ablation. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2007; 9(2): 127-9. 2007/01/11.
  • 29. Hjortshøj S, Dethlefsen C, Kristensen SR, Ravkilde J. Kinetics of ischaemia modified albumin during ongoing severe myocardial ischaemia. Clin Chim Acta 2009; 403(1-2): 114-20. 2009/04/14.
  • 30. Sinha MK, Gaze DC, Tippins JR, Collinson PO, Kaski JC. Ischemia modified albumin is a sensitive marker of myocardial ischemia after percutaneous coronary intervention. Circulation 2003; 107(19): 2403-5. 2003/05/14.
  • 31. Sinha MK, Vazquez JM, Calvino R, Gaze DC, Collinson PO, Kaski JC. Effects of balloon occlusion during percutaneous coronary intervention on circulating Ischemia Modified Albumin and transmyocardial lactate extraction. Heart (British Cardiac Society) 2006; 92(12): 1852-3. 2006/11/16.
  • 32. Quiles J, Roy D, Gaze D, Garrido IP, Avanzas P, Sinha M, et al. relation of ischemia-modified albumin (IMA) levels following elective angioplasty for stable angina pectoris to duration of balloon-induced myocardial ischemia. The American journal of cardiology 2003; 92(3): 322-4. 2003/07/31.

Ischemia modified albumin levels in distinguishing NSTEMI patients from non-ischemic controls and correlation with disease severity

Year 2021, Volume: 46 Issue: 4, 1566 - 1573, 30.12.2021
https://doi.org/10.17826/cumj.976875

Abstract

Purpose: The aim of this study was to investigate the diagnostic value of ischemia modified albumin (IMA) in early non-ST elevation myocardial infarction (NSTEMI) patients diagnosed with high-sensitive cardiac troponin (hs-cTn)assays.
Materials and Methods: In the first three hours of symptom onset, one hundred sixty-two patients without cardiovascular disease history admitted to our hospital with NSTEMI were enrolled between March 2018 and August 2019. The patients' IMA levels were compared with IMA levels of randomly selected, age and the sex-matched control group comprised of 61 subjects with normal coronary angiography results.
Results: IMA levels of NSTEMI patients were higher than the control group. In receiver operating characteristic (ROC) curve analysis, a value equal or greater than 0.3855 ABSU has an 82% sensitivity and a 99.4% specificity for diagnosing NSTEMI (AUC: 0.962, 95% CI: 0.937 – 0.986,). In addition, ROC curve analysis revealed moderate predictive power for distinguishing three-vessel disease (cut-off value: 0.4290 ABSU, sensitivity 78.4% and specificity 56.3%, AUC: 0.696, 95% CI: 0.616 – 0.776,). IMA levels were positively correlated with Gensini scores of the patient group.
Conclusion: Ischemia-modified albumin, when used alone, was very useful in distinguishing NSTEMI from non-ischemic controls. Besides, IMA levels were positively correlated with CAD severity.

References

  • 1. Puymirat E, Simon T, Cayla G, Cottin Y, Elbaz M, Coste P, et al. Acute Myocardial Infarction: Changes in Patient Characteristics, Management, and 6-Month Outcomes Over a Period of 20 Years in the FAST-MI Program (French Registry of Acute ST-Elevation or Non-ST-Elevation Myocardial Infarction) 1995 to 2015. Circulation 2017; 136(20): 1908-19. 2017/08/29.
  • 2. Twerenbold R, Badertscher P, Boeddinghaus J, Nestelberger T, Wildi K, Puelacher C, et al. 0/1-Hour Triage Algorithm for Myocardial Infarction in Patients With Renal Dysfunction. Circulation 2018; 137(5): 436-51. 2017/11/05.
  • 3. Boeddinghaus J, Twerenbold R, Nestelberger T, Koechlin L, Wussler D, Meier M, et al. Clinical Use of a New High-Sensitivity Cardiac Troponin I Assay in Patients with Suspected Myocardial Infarction. Clin Chem 2019; 65(11): 1426-36. 2019/10/02. doi: 10.1373/clinchem.2019.304725.
  • 4. Collet JP, Thiele H, Barbato E, Barthelemy O, Bauersachs J, Bhatt DL, et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. European heart journal 2020. 2020/08/30. 5. Sbarouni E, Georgiadou P, Voudris V. Ischemia modified albumin changes – review and clinical implications. Clinical Chemistry and Laboratory Medicine (CCLM) 2011; 49(2): 177.
  • 6. Collinson PO, Gaze DC. Biomarkers of cardiovascular damage and dysfunction--an overview. Heart, lung & circulation 2007; 16 Suppl 3: S71-82. 2007/07/10.
  • 7. Keating L, Benger JR, Beetham R, Bateman S, Veysey S, Kendall J, et al. The PRIMA study: presentation ischaemia-modified albumin in the emergency department. Emerg Med J 2006; 23(10): 764-8. 2006/09/22.
  • 8. Hjortshoj S, Kristensen SR, Ravkilde J. Diagnostic value of ischemia-modified albumin in patients with suspected acute coronary syndrome. The American journal of emergency medicine 2010; 28(2): 170-6. 2010/02/18. doi: 10.1016/j.ajem.2008.10.038.
  • 9. Christenson RH, Duh SH, Sanhai WR, Wu AH, Holtman V, Painter P, et al. Characteristics of an Albumin Cobalt Binding Test for assessment of acute coronary syndrome patients: a multicenter study. Clin Chem 2001; 47(3): 464-70. 2001/03/10.
  • 10. Peacock F, Morris DL, Anwaruddin S, Christenson RH, Collinson PO, Goodacre SW, et al. Meta-analysis of ischemia-modified albumin to rule out acute coronary syndromes in the emergency department. Am Heart J 2006; 152(2): 253-62. 2006/08/01.
  • 11. Sinha MK, Roy D, Gaze DC, Collinson PO, Kaski JC. Role of "Ischemia modified albumin", a new biochemical marker of myocardial ischaemia, in the early diagnosis of acute coronary syndromes. Emerg Med J 2004; 21(1): 29-34. 2004/01/22.
  • 12. Koc F, Erdem S, Altunkas F, Ozbek K, Gul EE, Kurban S, et al. Ischemia-modified albumin and total antioxidant status in patients with slow coronary flow: a pilot observational study. Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology 2011; 11(7): 582-7. 2011/09/14.
  • 13. Lippi G, Ferrari A, Gandini G, Gelati M, Lo Cascio C, Salvagno GL. Analytical evaluation of the new Beckman Coulter Access high sensitivity cardiac troponin I immunoassay. Clin Chem Lab Med 2017; 56(1): 157-61. 2017/07/14.
  • 14. Roffi M, Patrono C, Collet JP, Mueller C, Valgimigli M, Andreotti F, et al. 2015 ESC Guidelines for the Management of Acute Coronary Syndromes in Patients Presenting Without Persistent ST-segment Elevation. Rev Esp Cardiol (Engl Ed) 2015; 68(12): 1125. 2015/12/18.
  • 15. Bar–Or D, Lau E, Winkler JV. A novel assay for cobalt-albumin binding and its potential as a marker for myocardial ischemia—a preliminary report11Original Contributions is coordinated by John A. Marx, MD, of Carolinas Medical Center, Charlotte, North Carolina. The Journal of Emergency Medicine 2000; 19(4): 311-15.
  • 16. Hosmer DW, Lemeshow S. Applied logistic regression. New York: Wiley; 2008.
  • 17. Chek J, Dusek J, Stasek J, Vojacek J, Bis J, Ulrychova M, et al. Role of ischemia-modified albumin in estimating the extent and scope of cardiac ischemia in patients with ST elevation myocardial infarction. Heart and vessels 2011; 26(6): 622-7. 2011/01/27.
  • 18. Dominguez-Rodriguez A, Abreu-Gonzalez P, Garcia-Gonzalez MJ, Samimi-Fard S, Kaski JC. Relation of ischemia-modified albumin levels and left ventricular systolic function in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. Clinica chimica acta; international journal of clinical chemistry 2008; 388(1-2): 196-99.
  • 19. Bali L, Cuisset T, Giorgi R, Monserrat C, Quilici J, Carrega L, et al. Prognostic value of ischaemia-modified albumin in patients with non-ST-segment elevation acute coronary syndromes. Arch Cardiovasc Dis 2008; 101(10): 645-51. 2008/12/06.
  • 20. Bhagavan NV, Lai EM, Rios PA, Yang J, Ortega-Lopez AM, Shinoda H, et al. Evaluation of human serum albumin cobalt binding assay for the assessment of myocardial ischemia and myocardial infarction. Clin Chem 2003; 49(4): 581-5. 2003/03/26.
  • 21. Roy D, Quiles J, Aldama G, Sinha M, Avanzas P, Arroyo-Espliguero R, et al. Ischemia Modified Albumin for the assessment of patients presenting to the emergency department with acute chest pain but normal or non-diagnostic 12-lead electrocardiograms and negative cardiac troponin T. Int J Cardiol 2004; 97(2): 297-301. 2004/10/02.
  • 22. Collinson PO, Gaze DC, Bainbridge K, Morris F, Morris B, Price A, et al. Utility of admission cardiac troponin and "Ischemia Modified Albumin" measurements for rapid evaluation and rule out of suspected acute myocardial infarction in the emergency department. Emergency medicine journal : EMJ 2006; 23(4): 256-61.
  • 23. Anwaruddin S, Januzzi JL, Jr., Baggish AL, Lewandrowski EL, Lewandrowski KB. Ischemia-modified albumin improves the usefulness of standard cardiac biomarkers for the diagnosis of myocardial ischemia in the emergency department setting. Am J Clin Pathol 2005; 123(1): 140-5. 2005/03/15.
  • 24. Demirtas AO, Karabag T, Demirtas D. Ischemic Modified Albumin Predicts Critical Coronary Artery Disease in Unstable Angina Pectoris and Non-ST-Elevation Myocardial Infarction. J Clin Med Res 2018; 10(7): 570-75. 2018/06/16.
  • 25. Duarte MM, Rocha JB, Moresco RN, Duarte T, Da Cruz IB, Loro VL, et al. Association between ischemia-modified albumin, lipids and inflammation biomarkers in patients with hypercholesterolemia. Clinical biochemistry 2009; 42(7-8): 666-71. 2009/03/26.
  • 26. Piwowar A, Knapik-Kordecka M, Warwas M. Ischemia-modified albumin level in type 2 diabetes mellitus - Preliminary report. Disease markers 2008; 24(6): 311-7. 2008/08/09.
  • 27. Baydin A, Amanvermez R, Tuncel Ö K, Ocak M, Meric M, Cokluk C. Ischemia-modified albumin is not better than creatine kinase-MB and cardiac troponin I in predicting a cardiac injury in nontraumatic subarachnoid hemorrhage. The American journal of emergency medicine 2015; 33(4): 488-92. 2015/03/07.
  • 28. Sbarouni E, Georgiadou P, Panagiotakos D, Livanis EG, Theodorakis GN, Kremastinos DT. Ischaemia modified albumin in radiofrequency catheter ablation. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2007; 9(2): 127-9. 2007/01/11.
  • 29. Hjortshøj S, Dethlefsen C, Kristensen SR, Ravkilde J. Kinetics of ischaemia modified albumin during ongoing severe myocardial ischaemia. Clin Chim Acta 2009; 403(1-2): 114-20. 2009/04/14.
  • 30. Sinha MK, Gaze DC, Tippins JR, Collinson PO, Kaski JC. Ischemia modified albumin is a sensitive marker of myocardial ischemia after percutaneous coronary intervention. Circulation 2003; 107(19): 2403-5. 2003/05/14.
  • 31. Sinha MK, Vazquez JM, Calvino R, Gaze DC, Collinson PO, Kaski JC. Effects of balloon occlusion during percutaneous coronary intervention on circulating Ischemia Modified Albumin and transmyocardial lactate extraction. Heart (British Cardiac Society) 2006; 92(12): 1852-3. 2006/11/16.
  • 32. Quiles J, Roy D, Gaze D, Garrido IP, Avanzas P, Sinha M, et al. relation of ischemia-modified albumin (IMA) levels following elective angioplasty for stable angina pectoris to duration of balloon-induced myocardial ischemia. The American journal of cardiology 2003; 92(3): 322-4. 2003/07/31.
There are 31 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research
Authors

Süleyman Özbıçer 0000-0002-2016-0672

Gülhan yüksel Kalkan 0000-0002-6089-761X

Örsan Deniz Urgun 0000-0001-9125-4732

Salim Neşelioğlu 0000-0001-9125-4732

Özcan Erel 0000-0002-2996-3236

Publication Date December 30, 2021
Acceptance Date October 3, 2021
Published in Issue Year 2021 Volume: 46 Issue: 4

Cite

MLA Özbıçer, Süleyman et al. “Ischemia Modified Albumin Levels in Distinguishing NSTEMI Patients from Non-Ischemic Controls and Correlation With Disease Severity”. Cukurova Medical Journal, vol. 46, no. 4, 2021, pp. 1566-73, doi:10.17826/cumj.976875.