Ischemia modified albumin, high-sensitivity c-reactive protein and natriuretic peptide in patients with coronary atherosclerosis

Clin Chim Acta. 2009 Oct;408(1-2):65-9. doi: 10.1016/j.cca.2009.07.007. Epub 2009 Jul 19.

Abstract

Background: Ischemia modified albumin (IMA), is a new biomarker of oxidative processes involved with coronary artery disease (CAD). We determined serum IMA, high-sensitivity C-reactive protein (hsCRP), and natriuretic peptide (NT-proBNP), and evaluated their correlation with severity of coronary atherosclerosis in patients undergoing coronary angiography (CA). Cardiac troponin T (cTnT), CK-MB mass, albumin and Total Antioxidant Status (TAS) were also evaluated.

Methods: The study included 114 patients (88 men and 30 women) aged 43-80 years with documented CAD without evidence of acute coronary syndrome undergoing CA and 163 controls (131 men and 32 women) similarly aged.

Results: IMA, hsCRP and NT-proBNP were higher (p<0.001 and p=0.008 for NT-proBNP) while TAS was lower (p<0.001) in patients than in controls. IMA and TAS were negatively correlated in all subjects (p<0.01). Among patients, there was no correlation between IMA and the number of diseased vessels. For CAD diagnosis the best cut-off point for IMA was 101.5 KU/L with a sensitivity and a specificity of 87.7% and a negative predictive value of 83.3%. IMA was associated with an increased risk for CAD (OR=1.23, 95% CI: 1.16-1.31; p<0.001).

Conclusions: IMA determination may provide earlier information of CAD presence before hsCRP or NT-proBNP elevation, contributing to early assessment of overall patient risk.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antioxidants / metabolism
  • Biomarkers / blood
  • C-Reactive Protein / metabolism*
  • Case-Control Studies
  • Coronary Angiography
  • Coronary Artery Disease / blood*
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / pathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Natriuretic Peptides / blood*
  • Necrosis
  • Serum Albumin / metabolism*
  • Troponin T / blood

Substances

  • Antioxidants
  • Biomarkers
  • Natriuretic Peptides
  • Serum Albumin
  • Troponin T
  • C-Reactive Protein