The search for a myocardial ischemia marker. The case of albumin modified by ischemia

The search for a suitable and reliable marker of myocardial ischemia has led to the proposal of employing the cobalt binding capacity of total serum assuming that ischemic modifications of circulating albumin would markedly decrease its ability to bind cobalt. This test (IMA, Ischemia-Modified Album...

Full description

Bibliographic Details
Main Authors: Marco Bagnati, Matteo Basile, Barbara Toto, Giorgio Bellomo
Format: Article
Language:English
Published: PAGEPress Publications 2006-02-01
Series:Emergency Care Journal
Online Access:http://www.pagepressjournals.org/index.php/ecj/article/view/1345
_version_ 1818229097627648000
author Marco Bagnati
Matteo Basile
Barbara Toto
Giorgio Bellomo
author_facet Marco Bagnati
Matteo Basile
Barbara Toto
Giorgio Bellomo
author_sort Marco Bagnati
collection DOAJ
description The search for a suitable and reliable marker of myocardial ischemia has led to the proposal of employing the cobalt binding capacity of total serum assuming that ischemic modifications of circulating albumin would markedly decrease its ability to bind cobalt. This test (IMA, Ischemia-Modified Albumin) can be easily implemented on most of the technological platforms employed for clinical chemistry assays. It is simple and rapid and suitable for most of the diagnostic purposes of emergency medicine. This assay has been successfully employed to detect myocardial ischemia in various clinical studies and, despite a low specificity for myocardial ischemia, its high sensitivity and negative predictive value have pointed out its possible role as a first-line assay in clinical setting of patients with chest pain admitted to the Emergency Department. The low specificity toward ischemic events occurring to myocardium is challenging its use in clinical conditions associated with tissue ischemia or whole body hypoxia. Few caveat, however, must be taken into account. They include the clear identification of the proteins responsible for cobalt binding, the normalization of the results for the serum concentration of the binding sites, the standardizations of the assays employed. Large randomized trials are also absolutely needed to undoubtedly identify the potential and the limit of this new and promising biomarker.
first_indexed 2024-12-12T10:13:11Z
format Article
id doaj.art-ee09c269031c4512804cf2eabdae9c51
institution Directory Open Access Journal
issn 1826-9826
language English
last_indexed 2024-12-12T10:13:11Z
publishDate 2006-02-01
publisher PAGEPress Publications
record_format Article
series Emergency Care Journal
spelling doaj.art-ee09c269031c4512804cf2eabdae9c512022-12-22T00:27:44ZengPAGEPress PublicationsEmergency Care Journal1826-98262006-02-0121262910.4081/ecj.2006.1.26872The search for a myocardial ischemia marker. The case of albumin modified by ischemiaMarco Bagnati0Matteo Basile1Barbara Toto2Giorgio Bellomo3Laboratorio di Ricerche Chimico-Cliniche, Ospedale Maggiore della Carità, Università del Piemonte Orientale, NovaraLaboratorio di Ricerche Chimico-Cliniche, Ospedale Maggiore della Carità, Università del Piemonte Orientale, NovaraLaboratorio di Ricerche Chimico-Cliniche, Ospedale Maggiore della Carità, Università del Piemonte Orientale, NovaraLaboratorio di Ricerche Chimico-Cliniche, Ospedale Maggiore della Carità, Università del Piemonte Orientale, NovaraThe search for a suitable and reliable marker of myocardial ischemia has led to the proposal of employing the cobalt binding capacity of total serum assuming that ischemic modifications of circulating albumin would markedly decrease its ability to bind cobalt. This test (IMA, Ischemia-Modified Albumin) can be easily implemented on most of the technological platforms employed for clinical chemistry assays. It is simple and rapid and suitable for most of the diagnostic purposes of emergency medicine. This assay has been successfully employed to detect myocardial ischemia in various clinical studies and, despite a low specificity for myocardial ischemia, its high sensitivity and negative predictive value have pointed out its possible role as a first-line assay in clinical setting of patients with chest pain admitted to the Emergency Department. The low specificity toward ischemic events occurring to myocardium is challenging its use in clinical conditions associated with tissue ischemia or whole body hypoxia. Few caveat, however, must be taken into account. They include the clear identification of the proteins responsible for cobalt binding, the normalization of the results for the serum concentration of the binding sites, the standardizations of the assays employed. Large randomized trials are also absolutely needed to undoubtedly identify the potential and the limit of this new and promising biomarker.http://www.pagepressjournals.org/index.php/ecj/article/view/1345
spellingShingle Marco Bagnati
Matteo Basile
Barbara Toto
Giorgio Bellomo
The search for a myocardial ischemia marker. The case of albumin modified by ischemia
Emergency Care Journal
title The search for a myocardial ischemia marker. The case of albumin modified by ischemia
title_full The search for a myocardial ischemia marker. The case of albumin modified by ischemia
title_fullStr The search for a myocardial ischemia marker. The case of albumin modified by ischemia
title_full_unstemmed The search for a myocardial ischemia marker. The case of albumin modified by ischemia
title_short The search for a myocardial ischemia marker. The case of albumin modified by ischemia
title_sort search for a myocardial ischemia marker the case of albumin modified by ischemia
url http://www.pagepressjournals.org/index.php/ecj/article/view/1345
work_keys_str_mv AT marcobagnati thesearchforamyocardialischemiamarkerthecaseofalbuminmodifiedbyischemia
AT matteobasile thesearchforamyocardialischemiamarkerthecaseofalbuminmodifiedbyischemia
AT barbaratoto thesearchforamyocardialischemiamarkerthecaseofalbuminmodifiedbyischemia
AT giorgiobellomo thesearchforamyocardialischemiamarkerthecaseofalbuminmodifiedbyischemia
AT marcobagnati searchforamyocardialischemiamarkerthecaseofalbuminmodifiedbyischemia
AT matteobasile searchforamyocardialischemiamarkerthecaseofalbuminmodifiedbyischemia
AT barbaratoto searchforamyocardialischemiamarkerthecaseofalbuminmodifiedbyischemia
AT giorgiobellomo searchforamyocardialischemiamarkerthecaseofalbuminmodifiedbyischemia