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Ischemia-Modified Albumin Measurements in Symptom-Limited Exercise Myocardial Perfusion Scintigraphy Reflect Serum Albumin Concentrations but Not Myocardial Ischemia

Departments of¹ Cardiology, ² Nuclear Medicine, and³ Clinical Chemistry, Academic Medical Center, Amsterdam, The Netherlands;

^aaddress correspondence to this author at: Academic Medical Center, Department of Cardiology, Room B2-223, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; fax 31-20-6962609, e-mail p.m.vanderzee@amc.uva.nl

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The albumin cobalt-binding test (Ischemia Technologies), which measures the concentration of ischemia-modified albumin (IMA), has been cleared by the US Food and Drug Administration for use as a rule-out marker for acute myocardial ischemia (1). The test is based on the reduced capacity of human albumin to bind cobalt as a result of structural changes in the NH₂ terminus of the albumin molecule in conditions of myocardial ischemia (2)(3). Moreover, IMA concentrations correlated with disease severity in systemic sclerosis (4), and an exercise-induced decrease in IMA concentrations correlated with the ankle-brachial index in patients with peripheral artery sclerosis (5). Little is known, however, about the relationship between exercise-induced myocardial ischemia, albumin kinetics, and IMA kinetics. We therefore investigated this relationship in 38 patients with chest complaints and suspected coronary artery disease who were undergoing symptom-limited exercise myocardial perfusion scintigraphy. Myocardial perfusion scintigraphy was performed according to the guidelines of the American Society of Nuclear Cardiology (6), with a 2-day stress/rest protocol. A dose of 500 MBq of [^99mTc]-Tetrofosmin was administered at rest and at peak exercise. Electrocardiogram-gated single photon emission tomography imaging was started 45 min to 1 h after the administration of radioactive-labeled tracer. All patients exercised on a bicycle ergometer with a starting workload of 50 W, increasing every 2 min by 25 W. Endpoints for exercise included achievement of at least 85% of . . . [Full Text of this Article]

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				P O Collinson and D C Gaze Ischaemia-modified albumin: clinical utility and pitfalls in measurement J. Clin. Pathol., September 1, 2008; 61(9): 1025 - 1028. [Full Text] [PDF]

				E. Sbarouni, P. Georgiadou, G. N. Theodorakis, and D. Th. Kremastinos Reply J. Am. Coll. Cardiol., June 19, 2007; 49(24): 2376 - 2377. [Full Text] [PDF]

				E. Sbarouni, P. Georgiadou, G. N. Theodorakis, and D. Th. Kremastinos Ischemia-Modified Albumin in Relation to Exercise Stress Testing J. Am. Coll. Cardiol., December 19, 2006; 48(12): 2482 - 2484. [Abstract] [Full Text] [PDF]