Panimathi, R (2010) Ischemia modified albumin - An early marker of myocardial ischemia. Masters thesis, Stanley Medical College, Chennai.
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Abstract
INTRODUCTION Myocardial Ischemia occurs when there is an inadequate supply of blood to the myocardium resulting in an imbalance between myocardial oxygen supply and demand. The most common cause of Myocardial ischemia is an atherosclerotic disease of an epicardial coronary artery leading to a regional reduction in myocardial blood flow, followed by spasm, arterial thrombi, and rarely coronary emboli. Episodes of defective perfusion result in decreased myocardial tissue oxygen tension, and cause transient disturbance of mechanical, biochemical and electrical functions of the myocardium. More severe the block, more the damage to the myocardium, also in relation to the duration of oxygen supply. Early diagnosis of Myocardial Infarction at this stage itself can prevent morbidity and mortality. Though we have various myocardial proteins in the serum like CK-MB, LDH, AST and Troponins I and T for diagnosing Acute Myocardial Infarction, along with ECG, we should be able to identify myocardial ischemia before it progresses to irreversible myocardial cell damage. These markers are not elevated in the absence of necrosis when measured in the first 2 to 6 hours following an ischemic event. The present study on ischemia modified albumin has been found to be very useful for the detection of myocardial ischemia within 6 hours of onset of chest pain. Ischemia Modified Albumin (IMA) is measured by Albumin Cobalt Binding assay. It is based on the reduced binding affinity of human serum albumin for metal ions like Cobalt attributed to the free radical damage to the N - terminal region of albumin in patients with myocardial ischemia. The values are correlated with CK-MB and lipid profile. AIM OF THE STUDY : Aim of the study is to measure the Ischemia Modified Albumin by Albumin Cobalt Binding assay in patients, within 6 hours of onset of chest pain. OBJECTIVE : (1) To correlate the IMA values with CK-MB (2) Correlation of other markers of atherosclerosis like: (a) Total cholesterol, (b) Triacylglycerol, (c) High density lipoprotein, (d) Low density lipoprotein, (e) Very low density lipoprotein with IMA, (3) To prove the use of IMA as an early marker of myocardial ischemia. CONCLUSION : Biochemical markers such as CK-MB, Cardiac Troponin-I and Myoglobin are suitable only for assessing myocardial infarction. The results of the present study confirm the findings of previous studies, that reported that the Albumin Cobalt colorimetric assay distinguishes myocardial ischemic patients from non ischemic patients (p<0.001) Introduction of IMA assay for the first time provides emergency physicians with an objective diagnostic study to determine the presence of myocardial ischemia completely within the control of the emergency department. IMA assay presents a quantitative accurate laboratory determination of the occurrence of an Ischemic myocardial event, Angina of various types. Unlike the previous laboratory parameters that identify myocardial damage, only after it is well established, this test (Albumin Cobalt binding assay) helps to determine which patients will go in for severe occlusion. The introduction of IMA is a welcome event and based on the results obtained, the present study supports the hypothesis that Ischemia Modified Albumin is a useful marker for the early diagnosis of myocardial ischemia before any significant increase in CK-MB levels.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Ischemia modified albumin ; early marker ; myocardial ischemia. |
| Subjects: | MEDICAL > Biochemistry |
| Depositing User: | Subramani R |
| Date Deposited: | 05 Jul 2017 05:23 |
| Last Modified: | 05 Jul 2017 05:23 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/981 |
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